Health Psychology

Discrimination, religious affiliation, and arterial stiffness in African American women and men.
Objective: This study examined the interactive relations of experienced interpersonal discrimination, sex, and religious affiliation with pulse wave velocity (PWV), a noninvasive measure of arterial stiffness and indicator of subclinical cardiovascular disease (CVD) prognostic for clinical CVD. Method: We used multivariable linear regression analyses with cross-sectional data from 797 African American midlife adults in the Healthy Aging in Neighborhoods of Diversity Across the Life Span study in Baltimore, Maryland, to examine the interactive relations of both linear and quadratic discrimination, religious affiliation status, and sex with PWV in models adjusted for age and poverty status. Results: Findings revealed a significant three-way interaction of Discrimination² × Religious Affiliation Status × Sex with PWV (B = 0.004, SE = 0.001, p = .004). Simple effect analyses showed a U-shape relation for only religiously affiliated men (B = 0.001, SE = 0.001, p = .008). Both lower and higher levels of discrimination were related to higher PWV. No such relations emerged among unaffiliated men or women. Findings remained robust after sensitivity analyses adjusted for depressive symptoms, cigarette use, obesity, marital status, hypertension, Type 2 diabetes, CVD medical history, cholesterol, lipid-lowering medication use, systolic blood pressure, and heart rate. Conclusion: Religiously affiliated African American men who reported the lowest and highest experienced discrimination showed a heightened risk for subclinical CVD. Having a religious identity might either play a role in suppressing men’s unwanted memories of discrimination or increase men’s susceptibility to and salience of mistreatment, which might manifest in adverse cardiovascular health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The role of acculturation in the accuracy of type 2 diabetes risk perception: National Health and Nutrition Examination Survey 2011–2016.
Objective: High rates of undiagnosed Type 2 diabetes mellitus (T2DM) necessitate additional efforts to increase risk awareness, particularly among marginalized and immigrant populations. We examined the association of acculturation with the likelihood of accurate perception of T2DM risk in a large nationally representative sample of adults at risk for T2DM. Method: Participants were 5,034 adults, M (SD) age: 53 (23) years, 48% female. Acculturation was operationalized as length of time in the United States, and whether participants predominantly spoke English or their native language at home. Adults were considered to have accurate risk perception if they (a) met American Diabetes Criteria for prediabetes, and (b) self-reported their risk. Results: Less than half of the sample (33%) accurately perceived their T2DM risk. Logistic regression models adjusting for age, race, sex, education, insurance status, smoking, alcohol use, waist circumference, and family history of T2DM revealed that adults living in the United States up to 15 years were 1.35–2.33 times (ps< .04) as likely to inaccurately perceive their risk for T2DM compared to adults living in the United States >15 years and United States-born adults. Adults with lower versus higher English proficiency had a 41% (p = .03) increased likelihood of misperceiving their T2DM risk. Conclusions: Findings suggest that acculturation plays an important role in shaping T2DM risk perceptions among both nonimmigrant and immigrant populations. Increased cognizance of acculturation status (e.g., by healthcare providers) may be warranted to promote early T2DM risk detection and prevention at the population level. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Couple communication in cancer: A tale of two conceptual models.
Cancer poses significant challenges for patients and caregiving partners. Avoidant communication has been linked to poorer psychosocial adjustment to cancer. Two conceptual models have been proposed to account for this linkage: the social-cognitive processing and relationship intimacy models. Objective: To examine the utility of these models in explaining patient and partner psychological and relationship adjustment on a day-to-day basis using ecological momentary assessment. Method: Patients with breast, colorectal, or lung cancer and their partners (286 dyads) were prompted twice daily for 14 days via smartphone to answer questions about communication with their partner, adjustment (psychological distress and relationship satisfaction), and hypothesized mediators (avoidant thoughts and intimacy). Data were collected from 2017 to 2020. Results: Participants responded to 92% of prompts and completed 91%. Results supported the relationship intimacy but not the social-cognitive processing model. On afternoons when participants (both patients and caregivers) held back or perceived avoidance or criticism from their partner, they reported less intimacy, as did their partners; this lowered intimacy, in turn, led to participants’ (both patients’ and caregivers’) own lowered relationship satisfaction that evening and to patients’ lowered relationship satisfaction through caregivers’ lowered intimacy (one-tailed Bayesian ps <.025). When distress was the criterion, patients’ holding back or perceived avoidance/criticism led to their own increased distress through their own decreased intimacy, and caregivers’ holding back or perceived avoidance/criticism led to patients’ increased distress through patients’ lowered intimacy (one-tailed Bayesian ps <.005). Conclusions: Findings offer implications for interventions designed to improve communication and enhance closeness. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Implicit attitudes toward obesity-related cues and their relation to body mass index, psychosocial functioning, and health behavior.
Objective: Differences in automatic cognitive processes exist among individuals with overweight and obesity, thus there is a need to expand our conceptualization of overweight and obesity to emphasize the predictive utility of these automatic processes, rather than focusing solely on behavioral outputs. Implicit association tests (IATs) may afford a noninvasive method of examining automatic preferences that might contribute to overweight and obesity; namely, preferences for unhealthy foods and sedentary behavior versus healthy foods and physical activity. The purpose of the current study was to examine whether implicit attitudes toward foods and physical activity differed based on body mass index (BMI) status. The relationships between implicit attitudes and key psychosocial factors and health behaviors were also examined. Method: Participants (N = 127) included undergraduate students with an average age of 19.05 years old (SD = 1.52). Average BMI of the sample was 24.20 (SD = 4.93); 33.8% met criteria for overweight or obesity. Participants completed an IAT and questionnaires. Results: There were no differences in implicit preferences based on BMI or BMI status. Overall, the sample demonstrated implicit preferences for healthy foods and active words, and preferences were not linked to the corresponding behavioral outputs, though preferences were linked to various indices of emotion and emotion regulation. Conclusions: Future research should explore an extended model to examine how implicit preferences might impact intentions to engage in protective versus risky obesity-related health behaviors, and the various psychosocial factors that might impact the translation of those preferences and intentions in actual behavioral outputs. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Shared human papillomavirus vaccine readiness within families: A psychometric analysis of parent–adolescent dyads in France.
Background: In France, uptake of the recommended human papillomavirus (HPV) vaccination remains low. The vaccine cannot be administered without parental consent, but studies have shown that adolescents can make informed decisions about their health. We aimed at understanding the weight of adolescents’ vaccination intention in parents’ vaccination decision, using data from parent–adolescent dyads collected at baseline of a randomized trial of vaccine promotion interventions. Method: About 649 parent–adolescent dyads from 61 middle schools in France independently completed an online questionnaire on their knowledge and attitudes toward HPV vaccination, structured around the seven psychological domains of vaccine readiness (VR). We used multivariate and path analyses to understand the family decision-making process. Results: HPV vaccination was reported by 50.1% of adolescents and 45.5% of parents. Individual antecedents of VR were poorly correlated within dyads (r = .14–.36). Vaccine intentionality among parents of girls depended both on their own VR (β = .53, p <.001) and on their daughters’ vaccine intention (β = .25, p <.001). But among parents of boys, vaccine intention depended only on their own VR (β = .72, p <.001). Adolescents’ VR depended more strongly on the social environment’s attitude among boys than among girls (β = .54 vs. .34, p <.01). Conclusions: The defined model showed shared decision processes between parents and adolescent girls, but not boys, which can be understood in the context of a recent expansion of HPV vaccination to boys. Beyond this, it suggests that promotion targeting adolescents and their social environment can have a positive influence on parental intentions. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Better sleep, lower blood pressure, and less stress following sex: Findings from a large-scale ecological momentary assessment study.
Objective: Previous cross-sectional studies have shown that more (vs. less) sexually active individuals tend to be mentally and physically healthier, but little is known about the proximal mechanisms underlying such associations. Method: We analyzed two experience sampling data sets (N = 8,452, 66,181 observations; 72% male, age M = 46.42, 76% White) to examine changes in sleep, cardiovascular responses, and affect in the morning following sex, putative processes implicated in long-term mental and physical health benefits of sex. Results: Consistent with previous findings, our results showed significant between-person associations, suggesting more positive daily health outcomes for more sexually active individuals. Further, we found significant within-person associations suggesting that when people reported having (vs. not having) sex the previous night, they experienced better sleep quality, fewer sleep disturbances and shorter wake after sleep onset, lower blood pressure, less stress, more positive affect, and better coping in the morning. None of these associations were moderated by gender or relationship status. Conclusions: Our findings provide novel evidence suggesting short-term psychological and physiological benefits of sex, which may accrue to create better health over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Lung cancer patients’ illness perceptions: Prognostic for psychological and physical health trajectories.
Objective: Advanced nonsmall cell lung cancer (NSCLC) is associated with the highest burden of mental and physical symptoms. Across illnesses, patients’ subjective illness beliefs (i.e., illness perceptions [IPs]) correlate with psychological and physical health status. Despite this, IPs in NSCLC patients are understudied. To address this gap, previous research identified three profiles characterizing IPs of newly diagnosed NSCLC patients: “coping” (those more positive perceptions of NSCLC); “coping but concerned” (similar positive perceptions but high concern); and “struggling” (uniformly negative perceptions; Valentine et al., 2022). This extension seeks to determine if IPs are predictive. Would patients’ psychological and physical health trajectories differ by IP profile? Method: Patients with Stage IV NSCLC (N = 186) from a prospective cohort (2017–2019; NCT03199651) enrolled at diagnosis participated and completed an IP measure and anxiety, depression, physical symptom, and health status outcome measures monthly for 8 months. Linear mixed models tested profile membership (see above) as predictive of outcome trajectories, with those “struggling” having the poorest outcomes. Results: Eight-month trajectories for anxiety and some physical symptoms showed significant improvement, whereas depression, dyspnea, pain, and self-rated health did not. As anticipated, profile membership was predictive: “struggling” profile patients reported significantly worse anxiety and depression symptoms, physical symptoms, and health compared to “coping” patients. There were no interactions between profile and time. Generalization to samples from U.S. states with greater racial/ethnic diversity is unknown. Conclusion: Novel data show “struggling” profile patients to have uniformly negative outcomes and specify IP content relevant for inclusion in cognitive behavioral therapies. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Health Psychology - Vol 43, Iss 12