Annals of Behavioral Medicine最新文献

Objective: Emerging research suggests the use of certain strategies to cope with stressors relate to disease and mortality risk, and lifestyle habits may be underlying mechanisms. Studies show psychological symptoms (eg, anxiety) and states (eg, happiness) predict the likelihood of adopting an integrated lifestyle that encompasses key health-related behaviors, like smoking. Yet, whether psychological processes, including stress-related coping, influence the adoption of a healthy lifestyle is unknown. We investigated whether coping strategies typically deemed adaptive (eg, seeking emotional support) and maladaptive (eg, denial) relate to sustaining a healthy lifestyle over a 16-year follow-up. We also explored whether variability in the use of these strategies, reflecting attempts to find the best strategy for a given stressor, subsequently relates to lifestyle.

Methods: Women (N = 46 067) from the Nurses' Health Study II cohort reported their use of 8 coping strategies in 2001, from which we also derived coping variability levels (lower, moderate, greater). Health behaviors (eg, physical activity, smoking, sleep), self-reported every 4 years from baseline until 2017, were combined into a lifestyle score. Generalized estimating equations, controlling for baseline demographics and health-related factors, were performed.

Results: Most adaptive strategies and greater variability levels were associated with a higher likelihood of sustaining a healthy lifestyle (eg, active coping, relative risk [RR] = 1.09, 95% confidence interval [CI], 1.08-1.11), with the reverse evident with maladaptive strategies (eg, behavioral disengagement, RR = 0.94, CI, 0.93-0.95), but some unexpected results also emerged.

Conclusions: Findings highlight the importance of going beyond the usual (mal)adaptive categorization of coping strategies when investigating their predictive value with behavioral outcomes.

Background: Regular physical activity (PA) is associated with positive health outcomes; however, rates of regular PA are low. Positive psychology interventions are efficacious in other health contexts and may be useful for promoting regular PA.

Purpose: Phased development and pilot/feasibility testing of a positive psychology intervention to promote PA using the ORBIT model for behavioral treatment development.

Methods: Positive psychology and PA promotion content was translated (phase 1a) and refined (phase 1b) into two 6-week, group-based treatments: Positive psychology for PA (PPPA), and a standard PA promotion comparison condition (SPA). A feasibility test (phase 2a) for PPPA only (n = 13) and piloting (phase 2b) of PPPA (n = 30) and SPA (n = 11) were conducted at local YMCAs.

Results: In phase 2a, participants attended 59% of treatment sessions, completed 92%-100% of assessments at mid-treatment, post-treatment, and one-month post-treatment, and 83.3% had clinically meaningful increases in PA. Following refinement, phase 2b PPPA participants attended an average of 73% of the treatment sessions, 90% completed assessments at mid-treatment, post-treatment, and 1-month post-treatment, 73% at 6-month post-treatment, and 81% had clinically meaningful increases in PA. SPA participants attended 75% of sessions, completed 58%-82% of assessments across timepoints, and 66.7% had clinically meaningful increases in PA. Across timepoints, PPPA participants reported positive changes in PA enjoyment (dppc= 0.622-0.782), and positive affect (dppc= 0.162-0.407) relative to SPA, and recommended the study to others to help increase PA (95.4%) and happiness (88.6%).

Conclusions: This study supports the feasibility and acceptability of a positive-psychology-based, PA promotion intervention for increasing PA in low-active adults.

Background: Recent research has revealed that the use of specific medical interventions carries with it social stigma. This "intervention stigma" can pose an obstacle to the use and adoption of interventions that may otherwise be effective in managing medical conditions. Open-label placebos (OLPs) have been identified as a potential intervention for a variety of clinical and nonclinical conditions but are viewed with skepticism among lay populations.

Purpose: This online experimental study aimed to quantify intervention stigma associated with the use of OLP interventions for a medical condition within a warmth-competence framework of social perception.

Methods: In an online experiment fielded in the USA (N = 541), we randomly assigned participants to read 1 of 4 vignettes about a patient who is administered an OLP intervention by a physician for chronic back pain. In each vignette, the patient's belief in and response to the treatment varied. After reading the vignette, participants rated the patient on several characteristics that captured perceptions of warmth and competence.

Results: We found that patients who believed in the OLP intervention or reported improvement after taking it were perceived as less competent and warmer.

Conclusions: Our results suggest that the use of OLP interventions for medical conditions carries intervention stigma. We contend that this stigma poses an obstacle to the adoption of OLP interventions.

Behavioral interventions are widely used in clinical trials supported by the National Institutes of Health (NIH). When behavioral interventions involve group-formatted components and/or shared interventionists, they require special design and analytic methods not needed in trials that do not involve these features. The NIH Office of Disease Prevention (ODP) and the NIH Office of Behavioral and Social Sciences Research (OBSSR) offer resources to make it easier for investigators to use appropriate methods to evaluate these interventions. This commentary draws attention to these issues and highlights the ODP and OBSSR resources available to investigators. We urge investigators to take advantage of these resources to learn about and adopt appropriate sample size and analytic methods for trials to evaluate behavioral interventions so that their results will be reliable and reproducible. That is the best way to advance the science of behavioral interventions to improve health.

Background: Parents with children in the home may benefit considerably from sport participation, given the high levels of physical inactivity and psychosocial distress among this group. The purpose of this study was to evaluate the effectiveness of team sport participation on mental health (primary outcome) as well as other secondary psychosocial outcomes compared to an individual physical activity condition and a "date night" control condition among parents with young children (under the age of 13).

Methods: A three-arm parallel design single blinded randomized controlled trial compared the team sport (n = 58), individual physical activity (n = 60), and control condition (n = 66) over three months. Well-being variables (short-form-12, satisfaction with life scale, parental stress scale, relationship assessment scale, family inventory version II) were assessed at baseline and post-randomization at 6 weeks and 3 months. Rolling recruitment began in winter 2016 until spring 2023. Analyses were conducted using generalized linear mixed models.

Results: Team sport participation resulted in improvements in mental health and increased relationship satisfaction compared to the other conditions. Team sport participation also showed improvements in lowering parental stress and increasing family emotional expressiveness compared to the control condition. All conditions improved satisfaction with life, lowered stress, increased relationship satisfaction, benefited family health/competence and lowered family conflict over time.

Discussion: The findings extend prior observational research by demonstrating team sport participation may be a viable activity to recommend for parents of young children, who are typically challenged by lower well-being, stress, and social isolation from other adults.

Registered trial: The clinical trial is registered with the National Library of Medicine at the National Institutes of Health registration ID is NCT02898285.

Background: The association between stress and sexuality, both of which are linked to health, is unclear. We examined the feasibility of an ecological momentary assessment study including time-based and event-based measurements in this context (aim 1) and investigated concurrent and time-lagged bidirectional associations between subjective stress and sexual desire/arousal/activity in the daily lives of healthy individuals over 14 days (aim 2).

Purpose: The aim of this study was to gain insight into the interplay between stress and sexual experience and behavior while considering potential gender differences.

Methods: Between May 2015 and January 2016, 59 heterosexual, healthy men and women in relationships (M = 23.66 years old, SD = 2.86, range: 18-30 years) rated subjective stress, sexual desire, and sexual arousal at 6 fixed timepoints daily as well as after sexual activity. Feasibility was investigated considering dropout rates, missing data, and representativeness of data. Data were analyzed using mixed-effects models.

Results: Higher subjective stress was associated with a lower likelihood of concurrent sexual desire and arousal, and occurrences of sexual desire and arousal were associated with lower concurrent subjective stress. Sexual desire and activity were associated with lower subsequent subjective stress, and the latter association was stronger in women than in men. Rates of dropout, missing data, and nonrepresentative data were low.

Conclusions: There appear to be bidirectional associations between higher subjective stress and a lower likelihood of concurrent sexual desire and arousal. Sexual desire and sexual activity seem to be associated with lower subsequent subjective stress. The study design appears to be feasible, although the generalizability of the findings is limited. Future studies might explore stress reduction interventions to promote sexual health.

Objective: Feeling comfortable and safe has been discussed to foster health and well-being. However, the pathways to better health are complex, involving both behavioral and physiological routes.

Methods: In this study, we examined the role of safety perception for cardiac health by (1) examining associations with baseline heart rate variability (HRV; Study 1) and (2) evaluating a novel measure of autonomic cardiac flexibility in daily life, namely increases in HRV independent of metabolic demands (ImdHRVi; Study 2).

Results: Study 1 (N = 76) found evidence for a positive association between vagally mediated HRV and the Neuroception of Psychological Safety scale (Morton L, Cogan N, Kolacz J, et al. "A new measure of feeling safe: developing psychometric properties of the Neuroception of Psychological Safety Scale (NPSS)": Correction. Psychol Trauma. 2022; https://doi.org/10.1037/tra0001374), thus suggesting a link between safety and cardiac vagal regulation. In Study 2, a sample of N = 245 adult volunteers participated in a four-day-ambulatory assessment measuring HRV and bodily movement. A regression was calculated between HRV and bodily movement for 12 h of the first recording day, which was then used to calculate minute-by-minute ImdHRVi (beyond those predicted by bodily movement) in the following days. It turned out that safety perception predicted more episodes of ImdHRVi in everyday life, even after controlling for several confounds.

Conclusions: Findings suggest that feeling safe and everyday life cardiac autonomic regulation are interrelated, thus possibly contributing to adaptive adjustment and health.

Background: Identifying mechanisms of action can aid the refinement of weight management interventions. Acceptance and Commitment Therapy (ACT)-based interventions may support long-term weight management by improving self-regulation of eating behavior traits (EBTs). However, it remains unclear if changing EBTs like emotional eating, external eating, internal disinhibition, and restraint during ACT causes improved weight management.

Methods: For this 1-stage Individual Participant Data (IPD) meta-analysis, we requested IPD from 9 trials identified through a systematic search of ACT-based interventions for adults with a body mass index >25 kg/m2 across 8 databases until June 20, 2022. We obtained, checked, and harmonized data from 8 of those trials (N = 1391) and conducted separate structural equation models with complex survey analysis to estimate short- and long-term mediating effects of changes in each EBT on percent weight change.

Results: In the short-term (ie, follow-up closest to intervention end), we found indirect effects of the intervention on percent weight change through changes in emotional eating, external eating, internal disinhibition, and restraint. Each 1-unit change in these EBTs led to a 0.02% (95% CI, 0.05-0.001), 0.03% (95% CI, 0.06-0.001), 0.05% (95% CI, 0.11-0.02), and 0.09% (95% CI, 0.14-0.04) decrease in weight, respectively. In the long term (ie, 12 months after intervention end), we found both indirect and total effects for emotional eating, internal disinhibition, and restraint, with EBT changes explaining 23.78%, 23.12%, and 25.64% of total effects.

Conclusion: Findings suggest small partial mediating effects of ACT on weight through EBTs. Targeting EBTs may support improved weight management outcomes, particularly in the long term.