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Health Psychology - Vol 36, Iss 10

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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
  • Gender confirming medical interventions and eating disorder symptoms among transgender individuals.
    Objective: Studies indicate that transgender individuals may be at risk of developing eating disorder symptoms (EDS). Elevated risk may be attributed to body dissatisfaction and/or societal reactions to nonconforming gender expression, such as nonaffirmation of a person’s gender identity (e.g., using incorrect pronouns). Limited research suggests that gender-confirming medical interventions (GCMIs) may prevent or reduce EDS among transgender people. Method: Participants included 154 transfeminine spectrum (TFS) and 288 transmasculine spectrum (TMS) individuals who completed the Trans Health Survey. Serial multiple mediation analyses controlling for age, education, and income were used to examine whether body satisfaction and nonaffirmation mediate any found relationships between various GCMIs (genital surgery, chest surgery, hormone use, hysterectomy, and hair removal) and EDS. Results: For TFS individuals, the nonaffirmation to body satisfaction path mediated relationships between all GCMIs and EDS, although body satisfaction alone accounted for more of the indirect effects than this path for chest surgery. For TMS individuals, relationships between all GCMIs and EDS were mediated by the nonaffirmation to body satisfaction path. Conclusion: Findings support the hypothesis that GCMIs reduce experiences of nonaffirmation, which increases body satisfaction and thus decreases EDS. Among TFS participants, the relationship between chest surgery and lower levels of EDS was mediated most strongly by body satisfaction alone, suggesting that satisfaction with one’s body may result in lower EDS even if affirmation from the external world is unchanged. Implications of these findings for intervention, policy, and legal efforts are discussed, and future research recommendations are provided. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Cognitive behavioral therapy for body image and self-care (CBT-BISC) in sexual minority men living with HIV: A randomized controlled trial.
    Objective: Body image disturbance is a distressing and interfering problem among many sexual minority men living with HIV, and is associated with elevated depressive symptoms and poor HIV self-care (e.g., antiretroviral therapy [ART] nonadherence). The current study tested the preliminary efficacy of a newly created intervention: cognitive–behavioral therapy for body image and self-care (CBT-BISC) for this population. Method: The current study entailed a 2-arm randomized controlled trial (N = 44) comparing CBT-BISC to an enhanced treatment as usual (ETAU) condition. Analyses were conducted at 3 and 6 months after baseline. The primary outcome was body image disturbance (BDD-YBOCS), and secondary outcomes were ART adherence (electronically monitored via Wisepill), depressive symptoms (MADRS), and global functioning (GAF). Results: At 3 months, the CBT-BISC condition showed substantial improvement in BDD-YBOCS (b = −13.6, SE = 2.7, 95% CI [−19.0, −8.3], p <.001; dppc2 = 2.39); MADRS (b = −4.9, SE = 2.8, 95% CI [−10.6, .70], p = .086; dppc2 = .87); ART adherence (b = 8.8, SE = 3.3, 95% CI [2.0, 15.6], p = .01; dppc2 = .94); and GAF (b = 12.3, SE = 3.2, 95% CI [6.1, 18.6], p <.001; dppc2 = 2.91) compared with the ETAU condition. Results were generally maintained, or improved, at 6 months; although, adherence findings were mixed depending on the calculation method. Conclusions: CBT-BISC shows preliminary efficacy in the integrated treatment of body image disturbance and HIV self-care behaviors among sexual minority men living with HIV. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Effects of trauma and PTSD on self-reported physical functioning in sexual minority women.
    Objective: Sexual minority women (lesbians, bisexual women, and women who partner with women) experience high rates of trauma exposure, are more likely to develop posttraumatic stress disorder (PTSD), and have high rates of physical health problems compared with heterosexual women. The present study tested whether PTSD may be the mechanism through which trauma exposure affects self-reported physical functioning in this population. Method: In a sample of 857 sexual minority women, we examined the association between trauma exposure and worsening physical functioning (measured using the 12-item Short Form Health Survey) 2 years later, whether PTSD mediated this relationship, and if so, which PTSD symptom clusters best accounted for this mediation. Results: Results showed that more Criterion A traumatic events experienced (based on DSM–IV) predicted greater decline in physical functioning 2 years later, and PTSD symptoms mediated this relationship, explaining 73% of the total effect. The arousal/reactivity symptom cluster was the only significant mediator, explaining 68% of the total effect. Conclusions: Results show that PTSD, and arousal/reactivity symptoms in particular, may be the mechanism through which traumatic events negatively impact self-reported physical functioning. These findings provide further evidence that, for this at risk population, treating PTSD as soon as possible after onset may improve long term physical functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Adolescent sympathetic activity and salivary C-reactive protein: The effects of parental behavior.
    Objective: This study utilized a novel multisystem approach to investigate the effect of observed parental behavior on the relationship between biological mechanisms associated with disease processes (i.e., autonomic physiology and immune response) among their adolescent children. Method: Thirty-three adolescents (23 males), aged 11–13, and their parents participated in a laboratory session in which adolescents provided baseline measures of autonomic (sympathetic) activity, and adolescents and 1 parent participated in a laboratory based dyadic conflict resolution interaction task. This included 3 male parent/male adolescent dyads, 20 female parent/male adolescent dyads, 3 male parent/female adolescent dyads, and 7 female parent/female adolescent dyads. Approximately 3 years later, adolescents provided a salivary measure of C-Reactive Protein (sCRP) to index inflammation. Results: Analyses revealed a positive association between sympathetic activity and sCRP, as well as a moderating role of positive parental behavior in this relationship, such that the association between sympathetic activity and sCRP was greater among adolescents whose parents displayed shorter duration of positive affect. Conclusions: Overall findings indicate parental behavior may influence the association between adolescent sympathetic activity and inflammatory processes. These findings have important implications for understanding the impact of psychosocial factors on biological mechanisms of disease. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Does cognitive ability buffer the link between childhood disadvantage and adult health?
    Objective: Individual differences in childhood cognitive ability have been neglected in the study of how early life psychosocial factors may buffer the long-term health consequences of social disadvantage. In this study, we drew on rich data from two large British cohorts to test whether high levels of cognitive ability may protect children from experiencing the physical and mental health consequences of early life socioeconomic disadvantage. Method: Participants from the 1970 British Cohort Study (BCS; N = 11,522) were followed from birth to age 42, and those from the 1958 National Child Development Study (NCDS; N = 13,213) were followed from birth to age 50. Childhood social disadvantage was indexed using 6 indicators gauging parental education, occupational prestige, and housing characteristics (i.e., housing tenure and home crowding). Standardized assessments of cognitive ability were completed at ages 10 (BCS) and 11 (NCDS) years. Psychological distress, self-rated health, and all-cause mortality were examined from early adulthood to midlife in both cohorts. Results: Early social disadvantage predicted elevated levels of psychological distress and lower levels of self-rated health in both cohorts and higher mortality risk in the NCDS. Childhood cognitive ability moderated each of these relationships such that the link between early life social disadvantage and poor health in adulthood was markedly stronger at low (−1 SD) compared to high (+1 SD) levels of childhood cognitive ability. Conclusions: This study provides evidence that high childhood cognitive ability is associated with a decrease in the strength of socioeconomic status–driven health inequalities. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Longitudinal trajectories of benefit finding in adolescents with Type 1 diabetes.
    Objectives: Benefit finding, which refers to perceiving positive life changes resulting from adversity, has been associated with better psychosocial well-being in different chronic illnesses. However, little research to date has examined how benefit finding develops in the context of Type 1 diabetes (T1D). The present study aimed to identify trajectories of benefit finding across adolescence and to investigate prospective associations with depressive symptoms, self-care, and metabolic control. Method: Adolescents with T1D aged 10 to 14 (Mage = 12.49 years, 54% girls) participated in a 4-wave longitudinal study spanning 1.5 years (N = 252 at Time 1). Adolescents filled out questionnaires on benefit finding, self-care, depressive symptoms, and illness perceptions. HbA1c values were obtained through point of care assays. We used latent growth curve modeling (LGCM) and latent class growth analysis (LCGA) to examine the development of benefit finding. Cross-lagged path analysis and multi-group LGCM were used to examine prospective associations among the study variables. Results: Adolescents reported moderate levels of benefit finding which decreased over time. Three benefit finding trajectory classes were identified: low and decreasing, moderate and decreasing, and high and stable. These trajectory classes differed in terms of self-care, perceived personal and treatment control, and perceptions of illness cyclicality. Higher levels of benefit finding predicted relative increases in self-care 6 months later. Benefit finding was not prospectively related to depressive symptoms and metabolic control. Conclusions: Benefit finding may serve as a protective factor for adolescents with Type 1 diabetes and may motivate these adolescents to more closely follow their treatment regimen. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • The influence of pain memories on children’s and adolescents’ post-surgical pain experience: A longitudinal dyadic analysis.
    Objective: Although children’s pain memories have been shown to be a powerful predictor of subsequent pain experiences in acute procedural and experimental pain settings, little is known about the influence of children’s and parents’ pain memories on children’s future pain experiences in other painful contexts. This study used a dyadic approach to examine the roles of children’s and parents’ memories of pain on their subsequent reporting of postsurgical pain several months after the child underwent a major surgical procedure. Method: The sample included 66 parent–child dyads (Mage youth = 14.73 years, SD = 2.01) recruited from 2 tertiary level pediatric hospitals. At baseline, children and parents reported on their catastrophic thinking about the child’s pain. Parent and child reports of child pain were collected at approximately 1 month and 5 months postsurgery. At 2–4 months postsurgery, children’s and parents’ memories for postsurgical pain were assessed. Results: Results revealed that children’s, but not parents’, pain memories were a strong predictor of subsequent pain experienced at 5 months postsurgery. Children’s and parents’ memories for pain did not influence each others’ subsequent pain reporting. Conclusions: Findings suggest that children’s pain memories influence their continued recovery from postsurgical pain and may contribute to pain persistence. Implications for intervention and prevention are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Affective associations as predictors of health behavior in urban minority youth.
    Objective: Affective associations are key predictors of health-relevant action that can mediate the relationships between cognitive variables and health behavior. Little data, however, has examined affective associations in high-risk groups, the individuals with the greatest need for intervention. Further, few studies have examined the unique predictive ability of positive and negative affective associations. Methods: The present study assessed positive affective associations, negative affective associations, cognitive beliefs, subjective norms, and reports of 4 obesity-related behaviors (physical activity, fruit consumption, vegetable consumption, and soft drink consumption) across a cross-sectional (n = 1,499) and a longitudinal sample (n = 104) of predominantly African American adolescents of low socioeconomic status from the inner city of urban Detroit. Results: In both samples, positive (not negative) affective associations were the strongest and most consistent predictor of health behavior. Analyses also suggested that positive affective associations mediate the relationships between cognitive beliefs, subjective norms, and health behavior. Interaction tests revealed no evidence that the link between positive affective associations and health behavior is moderated by negative affective associations, cognitive beliefs, subjective norms, sex, or age. Conclusions: The results are consistent with affective association research and support the development of health interventions for urban minority youth aimed at changing positive (rather than negative) affective associations. The consistency across behaviors and the lack of reliable interactive effects suggests that changing positive affective associations may benefit urban youth regardless of behavior domain, age, sex, negative affective associations, subjective norm, and cognitive beliefs. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • The occurrence of earlier changes in family dynamics and friendship conflict predicting adolescent functional somatic symptoms: A large-scale prospective study.
    Objective: To better understand the role earlier stressful environments have in predicting functional somatic symptoms (FSS) in late adolescence, this study explores the effect the occurrence of earlier changes in family dynamics and friendship conflict have on FSS. Method: We used data from the Consortium for Longitudinal Studies on Child Abuse and Neglect (N = 1,314), a large, prospective study of children at risk for maltreatment and their parent/caregiver from approximately 4 to 18 years of age. Results: We found a significant, small (Effect Size = .10), positive association between the frequency of family dynamic change during middle childhood (ages 6–12 years) and FSS at age 18 but not during middle adolescence (ages 14 and 16). Conflict with a same-sex best friend at age 16 moderated the association between the frequency of change and FSS. The frequency of family dynamic change in middle childhood and middle adolescence was associated with greater FSS among those who reported greater conflict but not for those who reported experiencing lower conflict. Overall, these effects were specific to friendship conflict and remained when other friendship processes (intimacy and companionship) were included, did not generalize to anxiety/depressive symptoms, and predicted FSS without comorbid anxiety/depressive symptoms. No gender differences were found. The change–conflict interaction differed according to type of family dynamic change (parental vs. residential). Conclusion: Findings emphasize how earlier exposure to frequent changes in family dynamics in middle childhood is particularly associated with late-adolescent health, especially in the context of greater friendship conflict. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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