Health Psychology最新文献

Objective: To determine if and how cardiometabolic conditions (MetC) may be associated with posttraumatic stress disorder (PTSD) symptoms over time when controlling for the influence of potentially confounding variables.

Method: Parallel process latent growth modeling was applied to self-reported longitudinal data collected from 35,788 World Trade Center 9/11 survivors to determine how the development and course of PTSD symptoms and MetC influence each other when controlling for age, sex, race/ethnicity, preexisting traumas, physical health problems, general psychological distress, smoking, and alcohol use.

Results: A unidirectional relationship was found in which the intercept of PTSD symptoms predicted the slope of MetC. Hyperarousal (β = .172) and emotional numbing (β = .171) PTSD symptoms demonstrated the strongest association with MetC changes over and above the effects of control variables and potential confounders. Post hoc analyses indicated that utilization of PTSD-related psychotherapy was associated with decreased early presentations of MetC following trauma, which may have vital implications for the integrated treatment of trauma-exposed individuals.

Conclusions: Findings have strong theoretical and clinical implications for conceptualizing traumatic stress reactions as systemic processes and utilizing integrated treatment practices following psychological trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: To pilot and assess the feasibility, acceptability, and preliminary effects of the Rural Adult and Youth Sun (RAYS) protection program, a multilevel skin cancer preventive intervention for young children living in rural U.S. communities, delivered through community-organized team sports.

Method: Three rural counties in Utah participated with two receiving the intervention and the third serving as a control. Youth sports leagues were recruited through recreation departments and the study took place from May through October 2021. Intervention leagues received sun protection supplies for players and coaches, educational materials for parents, and coaches were offered training on skin cancer and sun protection behaviors.

Results: The RAYS program is both feasible to deliver and acceptable to coaches, parents, and players. The intervention also demonstrates beneficial preliminary effects on components of observed child sun-protective behaviors, coach sun protection behaviors, knowledge of skin cancer prevention recommendations, and self-efficacy in skin cancer prevention.

Conclusions: Multilevel interventions for skin cancer prevention among young children can be successfully delivered through community organizations and their settings. A priority moving forward is the identification of ways to optimize delivery of such programs to positively influence skin cancer preventive behaviors among children living in diverse rural areas. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: While a significant link between emotional well-being (EWB) and the gut microbiome has been reported recently, their temporal relationships remain elusive. This study aims to fill this gap by examining the longitudinal associations between EWB and the Shannon Index (SI), an indicator of gut microbiome diversity.

Method: The analysis focused on a dataset that collected participants' current EWB and fecal samples in both 2019 and 2022 (N = 57, 56.1% female, M_age = 52.47 years, SD = 12.65). Gut microbiome profiles were generated by sequencing the 16S rRNA gene, from which SI was subsequently calculated.

Results: The cross-lagged panel analysis revealed significant positive cross-sectional associations between EWB and SI in both 2019 (β = .296, SE = 0.121, p = .014) and 2022 (β = .324, SE = 0.119, p = .006). However, no significant longitudinal associations were found between 2019 EWB and 2022 SI (β = .068, SE = 0.138, p = .623), nor between 2019 SI and 2022 EWB (β = -.016, SE = 0.13, p = .899).

Conclusions: Our findings indicate that emotional happiness may be associated with gut microbiome profiles at a particular time point, but they may not serve as predictive factors for each other over time. Future research is needed to establish causal relationships between them. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Weight loss results from a negative energy balance, when energy intake (EI) is less than energy expended, e.g., from physical activity (PA). However, PA may impact energy balance beyond energy expenditure alone, through indirect effects on eating behavior. Yet, no research has examined if engaging in PA-a central component of most weight loss programs-is associated with same-day EI among individuals with overweight/obesity pursuing weight loss.

Method: Adults (N = 101) with overweight/obesity in a weight loss program were prescribed a reduced-calorie diet and PA regimen (250 min of moderate-to-vigorous PA at midtreatment). For 3 weeks at midtreatment, PA and EI were measured via an accelerometer and self-monitoring app, respectively. Multilevel models examined within-person relations between PA and EI preceding PA ("pre-PA"), acutely following PA ("acute post-PA," the 2 hr following PA), in the time following the acute post-PA period ("remaining time in day"), and across entire PA days ("full-day"), relative to non-PA matched time periods.

Results: EI was higher in the pre-PA and acute post-PA periods. There were no reliable differences in EI during the remaining time in day nor across the full-day on PA days versus within-subject matched non-PA days. There also was insufficient evidence to suggest EI pre-PA, post-PA, or across entire PA days, relative to non-PA matched time periods, was associated with percent weight change.

Conclusions: Findings suggest that engaging in PA was associated with different within-person EI patterns compared to non-PA days, though there was little evidence to support that these patterns relate to weight change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Having Type 1 diabetes (T1D) may complicate the normative developmental task of personal identity formation in adolescence and emerging adulthood. Besides exploring and committing to identity choices in different life domains, youth with T1D need to integrate their illness into their identity, a process labeled as illness identity. The present study examined whether youth with T1D belonging to different personal identity trajectory classes developed differently on four illness identity dimensions (acceptance, enrichment, engulfment, rejection).

Method: This four-wave longitudinal study over a 3-year period used self-report questionnaires to examine how personal identity trajectory classes were related to illness identity over time in youth with T1D (baseline: n = 558; 54% female; age range = 14-25 years). Personal identity trajectory classes were identified using latent class growth analysis. Differential development of the four illness identity dimensions among these personal identity trajectory classes was examined using multigroup latent growth curve modeling.

Results: Five personal identity trajectory classes were identified: achievement, foreclosure, moratorium, carefree diffusion, and troubled diffusion. Individuals in achievement and foreclosure displayed highest levels of diabetes integration (i.e., high levels of acceptance and enrichment; low levels of engulfment and rejection), whereas individuals in troubled diffusion displayed lowest levels of illness integration (i.e., low levels of acceptance and enrichment; high levels of engulfment and rejection).

Conclusions: The present study confirms that personal identity development relates to illness identity development over time in youth with T1D. Understanding the intricate link between personal and illness identity may help clinicians to tailor their interventions to patients' individual needs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Investigating factors that promote cardiovascular health outcomes is essential for secondary prevention. In a sample of coronary heart disease patients, we examined the direct and indirect effects of selected psychological factors on physical activity behavior and health-related quality of life (HRQoL) over 18 months.

Method: Patient-reported data were collected over three time points. Through structured equation modeling, a longitudinal path analysis was conducted to estimate the indirect effects of baseline HRQoL and cardiac self-efficacy on reported physical activity behavior and HRQoL (evaluated at 18 months) through the mediation of anxiety and depression symptoms, patients' reported intention to change the behavior, and emotions regulation strategies (evaluated at 9 months).

Results: A total of 410 patients were included. Significant indirect effects of baseline HRQoL (β = .05, 95% CI [-0.001, 0.111]) and cardiac self-efficacy (β = .105, 95% CI [0.06, 0.16]) on physical activity behavior were found, with anxiety symptoms and emotions regulation strategies as significant mediators. Additionally, the mediation of reported intention in the association between cardiac self-efficacy and physical activity levels was estimated. At the final follow-up, we also found a significant direct association between physical activity behavior and HRQoL (β = .12, p < .01), which was indirectly impacted by baseline HRQoL (β = .006, 95% CI [0.000, 0.017]) and cardiac self-efficacy (β = .012, 95% CI [0.003, 0.027]).

Conclusions: This study underlines the significance of addressing stress management, anxiety symptoms reduction, and cardiac self-efficacy enhancement when targeting better cardiovascular health outcomes. Identifying cardiovascular risk profiles based on these findings may benefit future clinical practice and further inform secondary prevention policy guidelines. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This study aimed to evaluate the effectiveness of an online multicomponent intervention called FATIGUEWALK (FaW) compared to treatment as usual (TAU) in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).

Method: FaW included pain neuroscience education, therapeutic exercise, cognitive restructuring, and mindfulness training. A total of 428 patients with CFS/ME were randomized into two study arms: online FaW plus TAU versus TAU alone. A single-blinded randomized controlled trial was conducted. Validated patient-reported outcome measures of fatigue, pain, anxiety, depression, and physical function were collected at baseline and posttreatment, following the FaW intervention, which lasted 12 weeks.

Results: Statistically significant improvements (with small-to-moderate effect sizes) were observed in online FaW versus TAU alone with respect to multidimensional aspects of fatigue (Cohen's d ranging from 0.25 to 0.73) and most secondary outcomes (pain and fatigue intensity, depressive and anxious symptomatology, functional impairment, kinesiophobia, physical functioning). The absolute risk reduction in FaW versus TAU was 19%, 95% confidence interval (CI) [12.19, 25.80] with number needed to treat = 6, 95% CI [3.9, 8.2]. Overall, similar clinical improvements were observed in sensitivity analyses including a subgroup of patients without comorbidity with fibromyalgia (n = 70).

Conclusions: This is the first study to assess the short-term effectiveness of an online multicomponent intervention added to TAU, compared to TAU alone, for the management of CFS/ME. Further trials, including active control groups with an equivalent treatment dose, and assessing the long-term effectiveness of the online FaW, are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Racial inequities in sleep health are well documented and may be partially attributable to discrimination experiences. However, the effects of acute discrimination experiences on same-night sleep health are understudied. We quantified naturalistic discrimination experiences captured using ecological momentary assessment (EMA) and examined whether reporting discrimination on a given day predicted sleep health that night.

Method: Participants completed baseline assessments and a 17-day EMA protocol, with text prompts delivered four times daily to collect discrimination experiences. Seven different daily sleep characteristics were ascertained each morning. Discrimination reasons (e.g., because of my racial identity) were reported by participants and categorized into any, racial, or nonracial discrimination. Outcomes included the seven sleep diary characteristics. We fit generalized linear mixed effects models for each sleep outcome and discrimination category, controlling for key covariates.

Results: The analytic sample included 116 self-identified Black and White individuals (48% Black, 71% assigned female at birth, average age = 24.5 years). Among Black participants, race-based discrimination was associated with a 0.5-hr reduction in total sleep time (TST). Among White individuals, nonracial discrimination was associated with a 0.6-hr reduction in TST, an earlier sleep offset, and reduced sleep efficiency (partly attributable to more nighttime awakenings).

Conclusions: Young adults may sleep worse on nights after experiencing discrimination, and different types of discrimination affect different sleep outcomes for Black and White individuals. Future studies may consider developing treatments that account for different sleep vulnerabilities for people experiencing discrimination on a given day. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Socioeconomic disadvantage during childhood and adolescence is associated with higher risk for many physical health problems, including infectious disease, throughout the lifespan. Greater negative affective (NA) reactivity has shown similar links to greater risk for physical health conditions and altered patterns of biological functioning associated with acute respiratory infection as socioeconomic disadvantage; yet their interactive effects on physical health outcomes have not been examined. Thus, the present study examined whether NA reactivity accentuated the link between early socioeconomic disadvantage and susceptibility to the common cold.

Method: Participants were 212 adults (42% female, 18-55 years old) who completed measures of childhood socioeconomic status (SES; parental home ownership) and were subsequently exposed to a virus that causes the common cold. Participants then remained quarantined for 5 days, during which multiple indicators of viral infection and clinical illness were assessed. Before and after quarantine, participants completed a laboratory stress task to assess NA reactivity.

Results: NA reactivity moderated the relationship between parental home ownership and clinical cold diagnosis in adulthood (b = -0.11, p = .018), such that fewer years of parental home ownership was associated with increased odds for developing a cold only among adults who had greater NA reactivity (OR = 0.89, 95% confidence interval, CI [0.82, 0.96]), but not among those who had lower NA reactivity (OR = 1.01, 95% CI [0.94, 1.09]).

Conclusions: These findings suggest that how individuals negatively react to psychosocial stressors in adulthood may exacerbate the impact of childhood SES on acute infection susceptibility. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Social participation is an important aspect associated with health-related outcomes in chronic diseases. However, little is known about the factors that may affect participation in patients with rheumatoid arthritis (RA). We aimed to examine whether pain, fatigue, anxiety, depression, and illness perception are associated with social participation in patients with RA when controlled for clinical and sociodemographic variables. We also analysed the mediating role of illness perception in the association between physical and psychological variables on social participation.

Method: We included 157 RA patients (84.7% females; mean age 56.4 ± 13.9 years) who completed the Participation Scale, Brief Illness Perception Questionaire, Generalized Anxiety Disorder Scale, Patient Health Questionnaire, 36-item Short Form Health Survey, and the Visual Analogue Scale. Multiple linear regressions and mediation analyses were used to analyze the data.

Results: In the final regression models, illness perception (β = .42; p ≤ .001) and functional disability (β = .21; p ≤ .05) were associated with social participation. Income (β = -.18; p ≤ .05) lost its significance when physical variables were added to the model, and pain (β = .24; p ≤ .05) and fatigue (β = -.24; p ≤ .05) when psychological distress was added. No significant role of anxiety, depression, disease activity, or age was identified using regression analyses. Illness perception mediated the association of pain, fatigue, anxiety, and depression with social participation, and the indirect effect varied from 65% to 98%.

Conclusions: Illness perceptions may significantly diminish the impacts of pain, fatigue, anxiety, and depression on social participation in individual RA patients. Therefore, RA patients could benefit from psychological interventions aimed at tackling negative illness perceptions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).