Health Psychology

Effectiveness of spiritual and religious interventions in patients with cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials.
Objective: This systematic review and meta-analysis aimed to combine the physiological, psychological, and spiritual health effects of spiritual and religious interventions on cardiovascular disease patients. Method: Studies from January 1999 to December 2022 were sourced from ScienceDirect, PubMed, Web of Science, Scopus, Cochrane CENTRAL, and cumulative index to nursing and allied health literature databases. This meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were analyzed using Comprehensive Meta-Analysis Version 4. Heterogeneity was assessed using 95% confidence intervals (CIs), p values, and fixed or random-effects models. Results: This systematic review included 15 studies with 2,047 participants, while the meta-analysis focused on 12 studies. Spiritual and religion-based interventions notably reduced participants’ heart rate (g = −0.287, 95% CI = [−0.552, −0.021]), anxiety (g = −1.081, 95% CI [−1.364, −0.831]), and depression (g = −1.346, 95% CI [−1.965, −0.726]). Moreover, these interventions significantly enhanced spiritual well-being (g = 0.692, 95% CI [0.459, 0.926]) and hope levels (g = 1.152, 95% CI [0.347, 1.956]) compared to control groups. Conclusion: This meta-analysis flashes on utilizing spiritual and religion-based interventions for nurses, chaplains, psychologists, social workers, and other professionals who might lead patient care to enhance health outcomes for cardiac patients. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Using word clouds to reveal patients’ perceptions about their arthritis.
Objective: Patients’ perceptions about their illness have the power to influence health outcomes. However, existing illness belief measures can be burdensome. Using word clouds to illustrate patients’ experiences is potentially a novel solution, but research is lacking in this area. This study aimed to explore whether word clouds illustrate patients’ perceptions about their illness and to determine commonalities and differences in experiences of rheumatic diseases. Method: A cross-sectional study was conducted with 323 patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or gout in New Zealand. Participants reported two words describing their inflammatory arthritis experience and completed the Brief Illness Perception Questionnaire. Word clouds were generated from participants’ responses, and analysis of variance models were used to explore perceptions between groups. Results: Eleven themes were identified, with each constituting a percentage of total word occurrence and weighting in word clouds. Symptom/sensation was the most prominent theme across all conditions (35%–61%), followed by affect/emotional experience (16%–25%). Theme prevalence varied across word clouds for each condition. Social impact was more prevalent for gout, and burden/intrusion was more prominent for ankylosing spondylitis. Functioning was less prevalent in the gout word cloud than in other conditions. There was moderate overlap between word cloud themes and illness perception domains. Word clouds uniquely identified themes related to burden/intrusion, functioning, opportunity, and social impact of illness. Conclusions: This study supports using word clouds as a low-burden method of examining the experiences of patients with inflammatory arthritis and could be tested with other patient groups. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Daily social resources as a buffer against stress eating and its consequences.
Objective: Eating in response to stress can become habitual and have long-term consequences for weight gain, but little research has explored what may help break stress-eating cycles. We examined daily social resources as potential protective factors against daily stress eating and eventual weight gain. Method: In Study 1 (N = 1,264), we assessed stress-eating tendencies, body mass index (BMI) and waist-to-hip ratio (WHR) at baseline, receipt of emotional support over 8 days (9,649 reports), and tracked BMI/WHR after about 10 years. We examined the average likelihood of receiving emotional support as a moderator of the link between stress eating and BMI/WHR at the follow-up. In Study 2 (N = 536; 10,288 reports), we assessed stress-eating status and BMI at baseline, social responsiveness (feeling that others are caring), and stress-eating behavior over 24 days and tracked BMI a year later. We examined if social responsiveness moderates stress-eaters’ daily stress-eating behaviors and changes in BMI. Results: In Study 1, stress eating predicted increases in BMI and WHR at the 10-year follow-up but not among individuals who were more (vs. less) likely to receive emotional support in daily life. In Study 2, stress eaters tended to report more daily stress-eating behaviors compared to nonstress eaters, but such tendency was attenuated on days they perceived high (vs. low) levels of social responsiveness. Stress eating did not predict BMI at the 1-year follow-up. Conclusions: These observational findings suggest that social resources in daily lives may have long-term benefits for stress eaters, potentially by reducing their everyday stress eating. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
The more the merrier? Two online experiments on how decoys can increase vaccine uptake.
Objective: During the COVID-19 pandemic, individuals in some countries had the option to choose from different vaccines, some of which were perceived as less favorable than others. Research on the decoy effect suggests that the preference for an option (target) increases when an inferior option (decoy) is added to the choice set. However, it is unknown whether the decoy effect occurs in vaccination decision making. Method: Two preregistered online experiments were conducted—a vignette experiment assessing hypothetical vaccination intentions (N = 1,268) and a behavioral experiment using an incentivized interactive vaccination game (N = 1,216)—and manipulated whether people were offered one vaccine (target) or two vaccines (target + decoy). Experiment 2 further tested four different types of decoys: the decoy was (a) a clone of the target or was inferior to the target in terms of (b) the probability of vaccine adverse events, (c) the severity of vaccine adverse events, or (d) vaccine effectiveness. The preference for the target vaccine (vs. nonvaccination) and the overall vaccine uptake were the main outcome variables. Results: Both experiments showed substantial decoy effects. In Experiment 2, decoys with more severe vaccine adverse events or reduced effectiveness increased the preference for the target vaccine and the overall vaccine uptake. Conclusion: Taken together, the results suggest that health communication programs must be designed carefully, as multiple options serve as evaluative anchors and might induce preference shifts. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Multilevel facilitators of pediatric asthma outcomes: The role of caregiver self-efficacy.
Objective: Caregivers’ self-efficacy for managing their child’s asthma appears to influence their success with managing their child’s disease. We examined how caregiver self-efficacy operates in the context of multilevel social-environmental support factors to shape asthma outcomes. Method: Caregivers of children (< 18 years old) with asthma completed surveys at baseline (T1) and 3 months later (T2). At T1, caregivers (n = 814) rated health care provider communication, family collaboration, community resources, socioeconomic status (SES), objective numeracy, caregiver global health, and caregiver self-efficacy for managing their child’s asthma. At T1 and T2 (n = 401), caregivers rated their asthma management behaviors and their child’s asthma-related morbidity and quality of life. We used structural equation models to test whether caregiver self-efficacy mediated the associations between support factors and outcomes. Results: For T1 caregiver asthma management behavior, we observed positive indirect effects through self-efficacy for community resources and caregiver global health, and an unexpected negative indirect effect for SES. For T2 caregiver asthma management behavior, we observed no indirect effects. For T1 child asthma-related morbidity, we found positive indirect effects through self-efficacy for community resources and caregiver global health, and a negative indirect effect for SES. For child asthma-related morbidity at T2, the indirect effects found at T1 remained significant. Conclusions: Social-environmental factors may be an underrecognized driver of caregiver self-efficacy and its consequent child asthma outcomes. Interventions focused on building resources at the community level and strategies that promote caregiver health could empower caregivers with greater self-efficacy and improve asthma outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Individual, dyadic, collaborative planning, physical activity, and nutrition: A randomized controlled trial in parent–child dyads.
Objective: This study was designed to investigate the effects of individual, dyadic, and collaborative planning on moderate-to-vigorous physical activity (MVPA; primary outcome) and energy-dense food intake (secondary outcome) in dyads of parents and their 9–15-year-old children. Individual planning reflects an “I-for-me” planning of one person’s behavior. Collaborative (“we-for-us”) planning refers to joint planning of both dyad members’ behavior, whereas dyadic (“we-for-me”) planning involves joint planning of only the target person’s behavior. Method: N = 247 dyads participated in a randomized controlled trial with individual, dyadic, or collaborative physical activity (PA) planning and control conditions (education about PA, sedentary behavior, nutrition, energy intake–expenditure balance). MVPA was measured with ActiGraph wGT3X-BT accelerometers at baseline, 1-week, and 36-week follow-ups. Energy-dense food intake was self-reported at baseline, 9-week, and 36-week follow-ups. Linear mixed models were fit for parents and children separately. Results: At the 36-week follow-up, children in the dyadic “we-for-me” planning condition decreased their MVPA compared to the control condition. At the same time, children in the dyadic planning condition also decreased energy-dense food intake at the 36-week follow-up. No effects were found among children in individual and collaborative PA planning conditions. Parents in any experimental conditions decreased energy-dense food intake. Conclusions: Children’s decrease in MVPA in dyadic PA planning condition was offset by a reduction of energy intake, which may represent a compensatory mechanism. The limited effectiveness of the dyadic “we-for-me” interventions in parent–child dyads may result from young people’s needs for individuation and their reactance to parental support. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
A dynamic bidirectional system of stress processes: Feedback loops between stressors, psychological distress, and physical symptoms.
Objective: Stress processes have long been of interest to researchers. A growing body of research explores the bidirectional relations between stressors, psychological and physical states. However, research on stress processes and their individual differences from a dynamic systems perspective is still lacking. This study examined dynamic feedback loops between stressors, psychological distress, and physical symptoms simultaneously using ecological momentary assessment. Method: Three hundred and fifty-six participants completed five momentary assessments on stressors, psychological distress, and physical symptoms per day for 7 days in 2023. They also completed measures of their Big Five personality traits, depressive symptoms, and anxiety symptoms. Results: Dynamic structural equation models showed positive cross-lagged and feedback effects of stressors with psychological distress and physical symptoms, suggesting their self-perpetuating loops. Agreeableness and conscientiousness were protective factors, and neuroticism was a risk factor for the stressor–psychological loop. Individuals with depressive and/or anxiety symptoms were characterized by (a) greater inertia of psychological distress and physical symptoms, (b) stronger reverse effects of psychological distress and physical symptoms on subsequent stressors, (c) significant reciprocal effects between psychological distress and physical symptoms, and (d) stronger self-perpetuating loops of stressors with psychological distress and physical symptoms. Conclusions: Our findings highlight the importance of analyzing feedback loops to understand bidirectional relations and individual differences in dynamic stress processes, providing insights for relevant personalized interventions. (PsycInfo Database Record (c) 2025 APA, all rights reserved)
Distress tolerance and perceived cancer-related cognitive impairment in nonmetastatic breast cancer.
Objective: Cancer- and cancer treatment-related cognitive impairment (CRCI) is reported by many women with breast cancer (BC). Distress tolerance (DT) refers to both the perceived capacity and behavioral act of withstanding uncomfortable/aversive/negative emotional and/or physical experiences. Poor DT has been associated with worse cognitive performance, including executive dysfunction. Importantly, DT can be improved through psychological interventions. However, DT research in cancer has been limited. This study aimed to examine the relationship between DT and CRCI in women with BC. Method: Women with nonmetastatic BC (n = 107, age ≥ 50 years) were recruited between 2016 and 2023, post BC surgery (54.2% lumpectomy and 38.3% mastectomy) but prior to adjuvant therapy, completed the Distress Tolerance Scale and the Functional Assessment of Cancer Therapy-Cognitive Scale, self-report measures of DT and CRCI, respectively. Hierarchical linear regression was used to test the associations between the DTS-Total Score (DTS-T) and CRCI on the Functional Assessment of Cancer Therapy-Cognitive subscales. Results: DTS-T was significantly associated with perceived cognitive impairment (CogPCI, p = .015), perceived cognitive abilities (CogPCA, p <.001), and quality of life impact (CogQOL, p = .010), after controlling for age and days since surgery. DTS-T explained 12%, 27%, and 12% of the variance in CogPCI, CogPCA, and CogQOL, respectively. Conclusion: Women with BC with greater ability to tolerate distress reported less CRCI, including less CogPCI, less CogQOL, and better CogPCA. Future directions should involve the use of objective measures of CRCI and longitudinal testing of its association with DT. (PsycInfo Database Record (c) 2025 APA, all rights reserved)

Health Psychology - Vol 44, Iss 2