Health Psychology最新文献

Objective: Youth from socioeconomically disadvantaged families are disproportionately at risk for developing cardiometabolic diseases. Underlying mechanisms, however, remain unclear. Therefore, we examined whether socioeconomic disadvantage was associated with structural variations in regions that underlie emotion processing and executive control, and whether those variations were in turn associated with cardiometabolic risk during adolescence. Primary areas of interest included the dorsolateral prefrontal (dlPFC) and orbitofrontal cortex (OFC), and secondary areas included the ventrolateral prefrontal cortex, amygdala, and hippocampus in sensitivity analyses.

Method: Participants were 277 racially and ethnically diverse adolescents (M_age = 13.92, 63% female, 73% youth of color) assessed in eighth grade (Time 1) and again 2 years later (Time 2). Caregivers' educational attainment and household income were used to index family socioeconomic status. Cardiometabolic risk was based on a composite score of signs of metabolic syndrome (i.e., waist circumference, blood pressure, cholesterol, triglycerides, glucose), and structural brain imaging data characterized brain volumes.

Results: Lower parent education was associated with smaller dlPFC volume, lateral OFC volume, and cardiometabolic risk at Time 1. Additionally, lower parent education and smaller dlPFC volume predicted greater cardiometabolic risk 2 years later at Time 2. Path analyses indicated that smaller dlPFC volume accounted for the association between parent education and cardiometabolic risk cross-sectionally and longitudinally 2 years later, but not for prospective changes in cardiometabolic risk.

Conclusion: Findings suggest that structural variation in the dlPFC may be a pathway connecting parent education to later cardiometabolic health problems. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Child abuse has been linked with obesity throughout the lifespan. The aim of the current study was to test two competing mechanisms underlying the association between child abuse exposure and obesity in childhood. Specifically, we examined whether depressive symptoms and the ratio of cortisol to dehydroepiandrosterone (DHEA), two hormones central to the stress response system, mediated the link between child abuse and obesity.

Method: This study employed a sample of 1,229 children all experiencing poverty (63.5% Black, 49.1% biological females). Approximately 40% of the participants were exposed to childhood physical, sexual, and/or emotional abuse (n = 471, 38.3%), as evidenced by coded Child Protective Service records. Cortisol and DHEA were measured with saliva samples taken in the morning across multiple days.

Results: Results of structural equation modeling indicated that children with abuse histories evidenced a lower cortisol/DHEA ratio, which was associated with a greater likelihood of childhood obesity. Importantly, this pathway held while controlling for a depressive symptom pathway, pointing to the unique influence of adrenocortical dysregulation in the child abuse-obesity link. Although child abuse was associated with greater depressive symptoms, depressive symptoms were not related to obesity.

Conclusion: These findings underscore that childhood adversity can "get under the skin" to affect health, even as early as childhood, and highlight that trauma-informed approaches to the clinical care of children with abuse histories represent a promising avenue for obesity prevention. Preventing child abuse occurrence and supporting children following abuse exposure may both be critical points of intervention for obesity prevention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Weight stigma among patients with obesity is a major risk factor for psychological and physical health comorbidities. Little is known, however, about experienced weight stigma (EWS) among metabolic bariatric surgery (MBS) patients in terms of pre- to post-MBS changes and correlates in the setting of significant weight loss. The current study utilized psychometrically validated measures to examine change in weight stigma from pre- to post-MBS and prospective associations with mental health, eating behaviors, and body mass index.

Method: Patients (N = 148) completed both pre-MBS psychological evaluation and follow-up assessment 1.5-3 years post-MBS, including measures of EWS, depressive symptoms, anxiety, binge eating, and disordered eating.

Results: EWS improved significantly pre- to post-MBS (by both statistical and clinically meaningful standards), and this change was associated with improvements in mental health, dysregulated eating, and reduced BMI. In regression models controlling demographic covariates and each outcome at baseline, both changes in and post-MBS EWS predicted mental health, dysregulated eating, and body mass index.

Conclusions: EWS improves significantly from pre- to post-MBS, and this is associated with improvements in mental health, decreases in dysregulated eating, and reduced weight. However, patients who continue to experience stigma are at elevated risk for ongoing psychological, eating, and weight challenges. Interventions must be designed to buffer the impacts of weight stigma to optimize the quality of life and long-term outcomes following MBS. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objectives: Social isolation, loneliness, and sleep problems have emerged as significant concerns in aging populations, yet longitudinal studies exploring their interconnections are limited. This study examined these relationships and performed subgroup analyses based on age and gender.

Method: Data were derived from the China Health and Retirement Longitudinal Study (2011, 2013, 2015, 2018, and 2020 waves; age ≥ 45 years, n = 7,622). The random intercept cross-lagged panel models (RI-CLPMs) were utilized to jointly examine the reciprocal effects between loneliness and sleep problems, as well as between social isolation and sleep problems in the total sample and within age and gender subgroups.

Results: Our findings revealed a bidirectional association between loneliness and sleep problems: sleep problems predicted later loneliness, β = .032, 95% confidence interval (CI) [0.019, 0.046], to .041, 95% CI [0.024, 0.057], and vice versa (β = .030, 95% CI [0.017, 0.042], to .037, 95% CI [0.021, 0.053]). Age and sex moderated the relationship between social isolation and sleep problems. Subgroup analyses showed a bidirectional pattern in older adults, with social isolation predicting later sleep problems (β = .031, 95% CI [0.009, 0.053], to .037, 95% CI [0.010, 0.064]), and the reverse association also observed (β = .024, 95% CI [0.001, 0.046], to .027, 95% CI [0.002, 0.052]). Among females, a unidirectional effect emerged, where social isolation predicted subsequent sleep problems (β = .021, 95% CI [0.002, 0.040], to .026, 95% CI [0.003-0.050]).

Discussion: Social isolation and loneliness exhibit distinct longitudinal relationships with sleep problems. Attention to loneliness and sleep problems should begin in middle age. Social isolation presents a greater threat to older adults and females, warranting further investigation in these populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objectives: Understanding public protective behaviors during pandemics is crucial for effective epidemic control. This study examines the longitudinal relationships between government intervention, risk perception, and adherence to social distancing policy throughout the pandemic (February 2020-December 2022) in South Korea.

Method: This study utilized a repeated cross-sectional survey conducted 73 times over a 3-year period (February 2020-December 2022). Each survey included 1,000 participants, resulting in a total sample size of 73,000. Meta-analysis and time series analysis were conducted on the entire data set, focusing on the COVID-19 variants of pre-Delta, Delta, and Omicron.

Results: Meta-analysis revealed a positive correlation between adherence to social distancing and risk perception, with the strongest effect observed during the Omicron surge. Time series analysis over the entire period found that government social distancing policies had a stronger effect on adherence to social distancing than physical risk or risk perception, highlighting the long-term impact of government interventions on public behavior.

Conclusions: This study quantitatively demonstrates the longitudinal heterogeneity between risk perception and adherence to social distancing and highlights the importance of government interventions, in addition to risk perception, in shaping public behaviors. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Risk for cardiovascular disease (CVD) increases sharply for women during midlife (aged 40-65). Physical activity (PA) is key during this time, though lack of social support is a primary barrier. The present study combined PA coaching with the formation of PA partnerships by pairing participants with each other for support during an 8-week behavioral PA intervention. This proof-of-concept study assessed feasibility, acceptability, and clinically significant change in the outcome and mediator of interest.

Method: Women in midlife with ≥ 1 risk factor for CVD (e.g., hypertension; N = 62, M_age = 52.6, M_BMI = 32.6 kg/m²) completed six weekly sessions with a PA coach, with assessment in Weeks 1 and 8; three sessions were joint meetings with their PA partner. They also completed daily ambulatory assessment and postintervention surveys. Data were collected in 2024 (NCT06350604).

Results: Recruitment (4.5 months), treatment adherence (97%), daily assessment compliance (84%), and retention (100%) all met or exceeded prespecified benchmarks, and sample characteristics showed strong representation from hard-to-reach groups (e.g., 20% household income < $50,000/year). Partners communicated on 47% of days (M = 3.5 times/week); PA increased by ∼500 steps/day from baseline (p < .01, d = 0.43) and 19% of participants increased by ≥ 2,000 steps/day. Acceptability was high (4.2/5) and ratings of PA-specific social support meaningfully increased (p < .001, d = 0.66).

Conclusion: Results demonstrate high acceptability and strong promise of partner-based PA intervention for improving cardioprotective behavior among women in midlife with elevated CVD risk. Thus, findings support larger scale testing with the inclusion of daily assessment, which can reveal mechanistic pathways linking social support to PA in daily life. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Vaccine hesitancy threatens global health, but vaccination rates for the seasonal flu are often suboptimal. Thus, it is important to develop and optimize interventions to reduce flu vaccine hesitancy. Vaccine lotteries-where chosen winners must be vaccinated to collect a monetary payout-could encourage vaccination through people's perceived likelihood of winning the lottery and anticipated regret. Antecedents of vaccination may also impact vaccine intentions.

Method: Adults from the United States who were unvaccinated for the flu (n = 598) were randomly assigned to read one of 12 scenarios regarding flu vaccine lotteries differing in structure (payout amount and number of winners).

Results: Adjusting for baseline flu vaccination willingness, structures with more money to fewer winners and $100 each to 50,000 winners led to greater vaccination intentions. Structures with larger payouts to fewer winners also generally resulted in lower perceived likelihood of winning and greater anticipated regret. Regression results showed that greater perceived likelihood and anticipated regret, as well as antecedents of greater confidence, less preference for deliberation, and greater collective responsibility about the flu vaccine, were associated with greater postscenario intentions. Secondary analyses found that antecedents of COVID-19 vaccination differed from those of the flu.

Conclusion: Results suggest that vaccine lotteries structured to award greater payout to fewer winners would be most likely to increase flu vaccine uptake, in contrast to a similar study conducted for COVID-19 in which lottery structure did not influence vaccination intentions (Taber et al., 2023). Results have implications for policy-makers designing financial incentive interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objectives: The landmark Hispanic Community Health Study/Study of Latinos (HCHS/SOL) enrolled N = 16,415 Hispanic/Latino adults (2008-2011) who have been followed for 12-16 years, through 2024. HCHS/SOL identified high rates of cardiovascular risk factors in the target population, with significant variability by Hispanic/Latino heritage (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American). In the current study, we reviewed the evidence from HCHS/SOL concerning the social, psychological, and cultural dimensions of cardiovascular health (CVH).

Method: Through a conceptual framework blending elements of the Reserve Capacity Model and Lifespan Biopsychosocial Model, we reviewed findings from 53 studies that have examined associations of broad socioeconomic (e.g., income) and immigration (e.g., place of birth) context, cognitive-emotional factors (e.g., depression symptoms), stress/adversity (e.g., chronic stress burden, discrimination stress), interpersonal (e.g., social support) and intrapersonal (e.g., optimism) resources, and cultural beliefs and values (e.g., fatalism, religiosity) with CVH and cardiovascular disease in HCHS/SOL.

Results: The studies reveal a consistent pattern of associations of adverse social drivers of health, such as low income and high chronic stress, as well as U.S. birth or more years living in the United States, and of greater depression and anxiety symptoms with worse CVH. Studies concerning protective interpersonal resources have produced variable results, and few studies have examined intrapersonal resources or cultural beliefs and values. Most studies have applied a cross-sectional design.

Conclusions: We conclude by discussing additional research needed to advance science regarding the social, psychological, and cultural dimensions of CVH among Hispanics/Latinos. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: This study aims to assess the effectiveness, ethics, and sustainability of nudge-based interventions in improving self-monitoring behaviors among patients with hypertension (HTN) and type 2 diabetes mellitus (T2DM).

Method: A systematic search of seven databases (January 2008-October 2024) identified studies on nudge-based interventions for HTN and T2DM self-monitoring. Nudge strategies were categorized using Münscher et al.'s taxonomy of choice architecture, which includes "decision information," "decision architecture," and "decision assistance." The included nudge-based interventions were evaluated across three domains: effectiveness, ethical quality, and sustainability.

Results: Seventeen studies (19 trials) were included in this review; 58% of the nudge-based interventions significantly improved self-monitoring adherence, and 47% yielded measurable improvements in clinical outcomes, such as reductions in blood pressure and glycated haemoglobin levels compared to usual care. Ethical evaluations revealed that the majority of nudge-based interventions exhibited above-average ethical quality. Regarding sustainability, while multicomponent interventions were common, they proved more difficult to implement due to higher resource demands.

Conclusions: This review highlights the potential of nudge-based interventions to improve self-monitoring adherence among patients with HTN and T2DM. However, balancing effectiveness, ethical considerations, and sustainability will be crucial for optimizing these interventions in real-world settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Purpose in life (PIL), referring to an individual's sense of direction and meaning, may enhance well-being among cancer survivors. However, its relationship with survival remains unclear. This study investigates the association between PIL and mortality among breast cancer survivors and explores potential underlying pathways.

Method: We analyzed 3,692 breast cancer survivors from the Women's Health Initiative, a cohort of postmenopausal women aged 50-79 recruited between 1993 and 1998. PIL was assessed in 2012 using a modified seven-item measure from Ryff and Keyes' Psychological Well-Being scale. Breast cancer cases and causes of death were confirmed through medical record review and death certificates. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs), with mediation analysis exploring underlying pathways.

Results: Over 9.1 years of follow-up, 1,627 women (44.1%) died. Women in the highest PIL quartile had a 33% lower mortality risk than those in the lowest quartile (HR = 0.67, 95% CI = [0.58, 0.78], p for trend < .0001). Stronger associations were observed among women under 70 (HR = 0.34, 95% CI = [0.19, 0.63]) and those diagnosed within the past year (HR = 0.28, 95% CI = [0.13, 0.58]). Physical activity, low perceived stress, and social engagement mediated 14.2%, 18.3%, and 13.7% of the association, respectively, collectively explaining 51% of the association.

Conclusion: Higher PIL is associated with improved survival in breast cancer survivors, with physical activity, stress reduction, and social engagement as key pathways. Goal-oriented interventions promoting PIL may improve survivorship outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).