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Health Psychology - Vol 36, Iss 12

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Health Psychology Health Psychology is a scholarly journal devoted to furthering an understanding of scientific relationships between behavioral principles on the one hand and physical health and illness on the other. The readership has a broad range of backgrounds, interests, and specializations, often interdisciplinary in nature. The major type of paper being solicited for Health Psychology is the report of empirical research.
Copyright 2017 American Psychological Association
  • Is subjective social status a unique correlate of physical health? A meta-analysis.
    Objective: Both social stratification (e.g., social rank) as well as economic resources (e.g., income) are thought to contribute to socioeconomic health disparities. It has been proposed that subjective socioeconomic status (an individual’s perception of his or her hierarchical rank) provides increased predictive utility for physical health over and above more traditional, well-researched socioeconomic constructs such as education, occupation, and income. Method: PsycINFO and PubMed databases were systematically searched for studies examining the association of subjective socioeconomic status (SES) and physical health adjusting for at least 1 measure of objective SES. The final sample included 31 studies and 99 unique effects. Meta-analyses were performed to: (a) estimate the overlap among subjective and objective indicators of SES and (b) estimate the cumulative association of subjective SES with physical health adjusting for objective SES. Potential moderators such as race and type of health indicator assessed (global self-reports vs. more specific and biologically based indicators) were also examined. Results: Across samples, subjective SES shows moderate overlap with objective indicators of SES, but associations are much stronger in Whites than Blacks. Subjective SES evidenced a unique cumulative association with physical health in adults, above and beyond traditional objective indicators of SES (Z = .07, SE = .01, p <.05). This association was stronger for self-rated health than for biologically based and symptom-specific measures of health. Almost all available data were cross-sectional and do not allow for strong causal inference. Conclusions: Subjective SES may provide unique information relevant to understanding disparities in health, especially self-rated health. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Perceived discrimination: Associations with physical and cognitive function in older adults.
    Objectives: Perceived discrimination has been associated with poor physical and psychological health. There is limited research examining perceived discrimination in older adults, and its effects on health in later life. The aim of this study is to extend research in this area by examining longitudinal associations between reported everyday discrimination and physical and cognitive function in older adults. Method: The present study uses a national sample of 4,886 community-dwelling individuals aged 60 years and older from the English Longitudinal Study of Ageing. Perceived discrimination was assessed at baseline by asking participants about the frequency with which they experienced 5 everyday discriminatory situations. Cognitive functioning, comprising tests of recall and a test of verbal fluency, and physical functioning, comprising a timed walk test, were measured identically at baseline and follow-up. Multiple regression analyses were performed, adjusting for sociodemographic and health status variables. Results: At baseline, 39.3% of participants reported being discriminated against at least a few times a year. After adjusting for demographic variables, health status, and depression, baseline discrimination was associated with poorer recall (B = −0.26, 95% CI [−0.44, −0.08]) and slower gait speed (B = −0.02, 95% CI [−0.03, −0.004]) at follow-up. Discrimination was not associated with poorer verbal fluency (B = −0.12, 95% CI [−0.45, 0.22]) at follow-up. Conclusions: The experience of discrimination is common among older adults and is associated with poorer physical and cognitive functioning. Addressing issues around discrimination in older adults may contribute to maintaining functioning in later life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Spouses’ daily feelings of appreciation and self-reported well-being.
    Objective: Research shows that active support provision is associated with greater well-being for spouses of individuals with chronic conditions. However, not all instances of support may be equally beneficial for spouses’ well-being. The theory of communal responsiveness suggests that because spouses’ well-being is interdependent, spouses benefit most from providing support when they believe their support increases their partner’s happiness and is appreciated. Two studies tested this hypothesis. Method: Study 1 was a 7-day ecological momentary assessment (EMA) study of 73 spouses of persons with dementia (74%) and other conditions. In Study 1, spouses self-reported active help, perceptions of how happy the help made the partner and how much the help improved the partner’s well-being, and spouses’ positive and negative affect at EMA time points. Study 2 was a 7-day daily assessment study of 43 spouses of persons with chronic pain in which spouses reported their emotional support provision, perceived partner appreciation, and their own physical symptoms. Results: Study 1 showed that active help was associated with more positive affect for spouses when they perceived the help increased their partner’s happiness and improved their partner’s well-being. Study 2 showed that emotional support provision was associated with fewer spouse reported physical symptoms when perceptions of partner appreciation were high. Conclusion: Results suggest that interventions for spouses of individuals with chronic conditions take into account spouses’ perceptions of their partners’ positive emotional responses. Highlighting the positive consequences of helping may increase spouses’ well-being. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • The role of a palliative care intervention in moderating the relationship between depression and survival among individuals with advanced cancer.
    Objective: Randomized controlled trials (RCTs) of early palliative care interventions in advanced cancer have positively impacted patient survival, yet the mechanisms remain unknown. This secondary analysis of 2 RCTs assessed whether an early palliative care intervention moderates the relationship between depressive symptoms and survival. Method: The relationships among mood, survival, and early palliative care intervention were studied among 529 advanced cancer patients who participated in 2 RCTs. The first (N = 322) compared intervention versus usual care. The second (N = 207) compared early versus delayed intervention (12 weeks after enrollment). The interventions included an in-person consultation, weekly nurse coach-facilitated phone sessions, and monthly follow-up. Mood was measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. Cox proportional hazard analyses were used to examine the effects of baseline CES-D scores, the intervention, and their interaction on mortality risk while controlling for demographic variables, cancer site, and illness severity. Results: The combined sample was 56% male (M = 64.7 years). Higher baseline CES-D scores were significantly associated with greater mortality risk (hazard ratio [HR] = 1.042, 95% confidence interval [CI] [1.017, 1.067], p = .001). However, participants with higher CES-D scores who received the intervention had a lower mortality risk (HR = .963, CI [0.933, 0.993], p = .018) even when controlling for demographics, cancer site, and illness-related variables. Conclusion: This study is the first to demonstrate that patients with advanced cancer who also have depressive symptoms benefit the most from early palliative care. Future research should be devoted to exploring the mechanisms responsible for these relationships. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Evaluation of coping as a mediator of the relationship between stressful life events and cancer-related distress.
    Objective: Lifetime stressful life events (SLEs) may predispose oncology patients to cancer-related distress (i.e., intrusive thoughts, hyperarousal, avoidance). Coping may influence cancer-related distress by mediating this relationship. This study sought to (a) determine the prevalence and impact of lifetime SLEs among oncology outpatients receiving chemotherapy and (b) examine the relationship between SLEs and cancer-related distress and the mediating role of coping on this relationship. Method: Patients (n = 957), with breast, gastrointestinal, gynecologic or lung cancer, who were undergoing chemotherapy, completed the Life Stressor Checklist–Revised (LSC-R), a measure of lifetime SLEs. Cancer-related distress was assessed with the Impact of Event Scale–Revised. Coping strategies since beginning chemotherapy were assessed with the Brief COPE; 2 latent variables (engagement and disengagement coping) were identified based on these scores. LSC-R scores (number of SLEs and perceived impact during the prior year) were evaluated in relation to demographic and clinical characteristics. Structural equation modeling was used to evaluate the relationship between LSC-R and Impact of Event Scale–Revised scores and the mediating role of engagement and disengagement coping on this relationship. Results: On average, patients reported 6.1 (SD = 4.0; range = 0–23 out of 30) SLEs. Patients who were not married/partnered, had incomes
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  • South Asian ethnicity, socioeconomic status, and psychological mediators of faecal occult blood colorectal screening participation: A prospective test of a process model.
    Objective: Although ethnicity and socioeconomic status (SES) correlate with health inequality, efforts to explain variance in health behavior attributable to these factors are limited by difficulties in population sampling. We used ethnicity identification software to test effects of psychological beliefs about screening as mediators of ethnicity and SES on faecal occult blood colorectal screening behavior in a no-cost health care context. Method: Adults aged 50–67 years (N = 1,678), of whom 28% were from minority South Asian religiolinguistic ethnic groups (Hindu-Gujarati/Hindi, Muslim-Urdu and Sikh-Punjabi), participated in a prospective survey study. Subsequent screening participation was determined from medical records. Results: Screening nonparticipation in the most deprived SES quintile was 1.6 times that of the least deprived quintile. Nonparticipation was 1.6 times higher in South Asians compared with non-Asians. A process model in which psychological variables mediated effects of ethnicity and SES on uptake was tested using structural equation modeling. Self-efficacy and perceived psychological costs of screening were, respectively, positive and negative direct predictors of uptake. Paths from Hindu, Muslim, and Sikh ethnicity, and SES on uptake were fully mediated by lower self-efficacy and higher perceived psychological costs. Paths from South Asian ethnicity to participation via self-efficacy and psychological costs were direct, and indirect via SES. Conclusion: SES is implicated, but does not fully account for low colorectal screening uptake among South Asians. Targeting increased self-efficacy and reduced perceived psychological costs may minimize health inequality effects. Future research should test independent effects of SES and ethnicity on lower self-efficacy and higher psychological costs. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Death narratives and cervical cancer: Impact of character death on narrative processing and HPV vaccination.
    Objectives: Narratives hold promise as an effective public health message strategy for health behavior change, yet research on what types of narratives are most persuasive is still in the formative stage. Narrative persuasion research has identified 2 promising features of such messages that could influence behavior: whether characters live or die, and whether characters encounter key barriers. This study investigated the effects of these 2 narrative message features on young women’s HPV vaccination intentions and examined mediating psychological processes of narrative persuasion in the context of cervical cancer messages. Method: We manipulated these 2 features in a narrative HPV vaccine intervention targeted to a national sample of U.S. women 18–26 who had not initiated the vaccine (N = 247). Participants were randomized in a 2 × 2 between-subjects experiment. Results: Compared to death narratives, survival narratives increased narrative believability and self-efficacy while lowering perceived barriers to vaccination. As features interacted, survival narratives featuring social barriers led to greater narrative transportation (absorption into the story) than other combinations. Moderated mediation analysis tested 10 theoretically derived mediators; transportation and risk severity mediated the narrative–intention relationship. Conclusions: Findings provide evidence for key psychological postulates of narrative persuasion theory. Results inform practical application for the construction of effective narrative message content in cervical cancer prevention campaigns for young women. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • The importance of the neighborhood in the 2014 Ebola outbreak in the United States: Distress, worry, and functioning.
    Objective: Ebola media coverage directed public attention to potential disease carriers: residents or travelers from West Africa. We investigated the role of neighborhood population factors (i.e., the concentration of West African foreigners, non–West African foreigners, non-Hispanic Blacks) on individual responses to the Ebola outbreak in the United States. The role of these community-level factors in emotional responses to this public health crisis is poorly understood. Method: Demographic factors, mental health, and stressful event history, collected as part of an ongoing longitudinal study of residents from 2 metropolitan communities (New York City and Boston, total N = 1,346), were combined with neighborhood data from the U.S. Census. Multilevel models estimated the effects of individual and neighborhood factors on individual psychological distress, functional impairment, and Ebola-related worry. Results: Individuals living in neighborhoods with more West African–born foreigners or non–West African foreigners reported more somatization and anxiety symptoms, functioning difficulties, and/or Ebola-related worry than individuals living in neighborhoods with fewer foreign residents (p <.05). Individuals residing in neighborhoods with more non-Hispanic Blacks also reported more somatization symptoms than their residential counterparts (p <.05). Conclusion: Neighborhood demography is important to study during a public health outbreak like Ebola in which media and policy target specific people or regions. Findings suggest research and policies should not only assist at-risk individuals but also at-risk neighborhoods during and after an infectious disease crisis. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Physical activity and negative affective reactivity in daily life.
    Objective: The results from experimental studies indicate that physically active individuals remain calmer and report less anxiety after the induction of a standardized stressor. The current study extends this research to real life, and examines whether daily physical activity attenuates negative affect that occurs in response to naturally occurring daily stressors. Method: The current study used data from the second wave of the National Study of Daily Experiences, a sub-study of the second wave of the Midlife in the United States Study (MIDUS-II) of 2,022 individuals aged 33-84 questioned nightly for eight consecutive days about their general affect and affective responses to stressful events and their engagement in physical activity. Results: Results indicated that while negative affect is significantly elevated on days with stressful events compared to days free of events in all individuals, these effects are attenuated in those who remain physically active when compared to those who were underactive. This was also true for any day participants were physically active. Importantly, negative affect in response to any specific stressor was reduced the closer in time that the stressor occurred to the bout of exercise in underactive participants, while, in active participants, negative affect in response to any stressor remained low throughout the entire day that participants reported that they were active. Conclusion: Given the significant mental and physical health implications of elevated affective reactivity observed in previous studies, the current study sheds further light on the importance of remaining physically active in times of stress. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Buffer or amplifier? Longitudinal effects of social support for functional autonomy/dependence on older adults’ chronic pain experiences.
    Objective: This longitudinal study aimed to investigate (a) the moderating role of formal social support for functional autonomy versus dependence on the relationship between pain intensity and pain-related disability among older adults with chronic pain and (b) the mediating role of pain-related self-efficacy and pain-related fear in this moderation. Method: One hundred and seventy older adults (Mage = 78.0; SD = 8.7) with chronic musculoskeletal pain participated in a 3-month prospective study, with 3 measurement moments. Participants filled out the Formal Social Support for Autonomy and Dependence in Pain Inventory, the Portuguese versions of the Brief Pain Inventory, the Pain Self-Efficacy Questionnaire, and the Tampa Scale of Kinesiophobia. Results: Using structural equation modeling, it was found that perceived promotion of autonomy, at Time 1, moderated the relationship between pain intensity (T1) and pain-related disability (T2); this moderation was fully mediated by pain-related self-efficacy (T2). Perceived promotion of dependence was not a significant moderator. Conclusions: These findings highlight the importance of social support for functional autonomy in buffering the impact of pain intensity on older adults’ pain-related disability. Also, they clarify the role of pain-related self-efficacy in this effect. Implications for the development of intervention programs, with formal caregivers, to reduce the impact of chronic pain on older adults’ healthy ageing process, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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