Health Psychology

Davidson, Karina W.; Trudeau, Kimberlee J.; Smith, Timothy W.

doi: 10.1037/0278-6133.25.1.1pmid: N/A

Irwin, Michael R.; Cole, Jason C.; Nicassio, Perry M.

doi: 10.1037/0278-6133.25.1.3pmid: 16448292

Meta-analyses support the effectiveness of behavioral interventions for the treatment of insomnia, although few have systematically evaluated the relative efficacy of different treatment modalities or the relation of old age to sleep outcomes. In this meta-analysis of randomized controlled trials (k = 23), moderate to large effects of behavioral treatments on subjective sleep outcomes were found. Evaluation of the moderating effects of behavioral intervention type (i.e., cognitive-behavioral treatment, relaxation, behavioral only) revealed similar effects for the 3 treatment modalities. Both middle-aged adults and persons older than 55 years of age showed similar robust improvements in sleep quality, sleep latency, and wakening after sleep onset. A research agenda is recommended to examine the mechanisms of action of behavioral treatments on sleep with increased attention to the high prevalence of insomnia in older individuals.

Smith, Michael T.; Perlis, Michael L.

doi: 10.1037/0278-6133.25.1.15pmid: 16448293

Chronic insomnia impacts 1 in 10 adults and is linked to accidents, decreased quality of life, diminished work productivity, and increased long-term risk for medical and psychiatric diseases such as diabetes and depression. Recent National Institutes of Health consensus statements and the American Academy of Sleep Medicine's Practice Parameters recommend that cognitive-behavioral therapy for insomnia (CBT-I) be considered the 1st line treatment for chronic primary insomnia. Growing research also supports the extension of CBT-I for patients with persistent insomnia occurring within the context of medical and psychiatric comorbidity. In the emerging field of behavioral sleep medicine, there has yet to be a consensus point of view about who is an appropriate candidate for CBT-I and how this determination is made. This report briefly summarizes these issues, including a discussion of potential contraindications, and provides a schematic decision-to-treat algorithm.

Clark, Rodney

doi: 10.1037/0278-6133.25.1.20pmid: 16448294

This quasi-experimental study explored the association of perceived racism and seeking social support to vascular reactivity in a college sample of 110 Black women. Perceived racism and seeking social support were assessed via self-report, and vascular reactivity was measured before and during a standardized speaking task. Hierarchical regression analyses indicated that perceived racism was positively related to changes in systolic blood pressure. These analyses also indicated that seeking social support moderated the relationship between perceived racism and systolic blood pressure changes. This interaction effect persisted after controlling for several potential confounders. Follow-up regression analyses showed that perceived racism was positively associated with reactivity among participants who were low in seeking social support. A significant relationship was not observed between perceived racism and systolic blood pressure changes among participants who were high in seeking social support. Perceived racism and seeking social support were not significantly associated with changes in diastolic blood pressure. These findings highlight the importance of examining psychosocial factors that may mitigate the hypothesized relationship between perceived racism and reactivity.

Evans, W. Douglas; Powers, Anne; Hersey, James; Renaud, Jeanette

doi: 10.1037/0278-6133.25.1.26pmid: 16448295

This purpose of this article is to explore differences by gender and school grade in patterns of association among social influences and tobacco use. Data from the 1999 (N = 15,038) and 2000 (N = 35,828) National Youth Tobacco Survey (American Legacy Foundation, 1999, 2000), a nationally representative, repeated cross-sectional survey, were used in the analysis. The authors compared effects on adolescent smoking. Direct paths from social environment to current smoking increased from middle school to high school. Indirect paths with social image mediating this relationship revealed a smaller increase. The pattern was constant across subsamples. Social image of smokers mediated the influence of social environment on adolescent smoking. Social image had a greater effect on smoking among middle school boys and high school girls.

Jackson, Kristina M.; Aiken, Leona S.

doi: 10.1037/0278-6133.25.1.34pmid: 16448296

An appearance-based sun-protection intervention program was developed, implemented, and evaluated in a sample of 211 Caucasian women (ages 18–25) randomly assigned to the sun-protection program or to a stress management (control) program. The sun-protection program incorporated a novel construct of image norms of aspirational peers (i.e., female media figures, fashion models) approving paleness. The authors targeted these image norms as well as the advantages of tanning, health beliefs about photoaging and skin cancer, and self-efficacy for sun protection. The intervention produced significant differences across conditions favoring sun protection on all constructs but severity of skin cancer and barriers to sun protection. At follow-up, treatment participants exceeded controls both in intention to sun protect and sun-protective behavior and reported lower intention to sunbathe and fewer hours of sunbathing. A mediational model of intervention outcomes revealed distinct mediators for sun protection versus sunbathing.

Bellizzi, Keith M.; Blank, Thomas O.

doi: 10.1037/0278-6133.25.1.47pmid: 16448297

Wide variability exists with respect to how breast cancer survivors respond to common psychological and psychosocial challenges of their disease, ranging from posttraumatic stress disorder to posttraumatic growth. This cross-sectional study examined contextual, disease-related, and intraindividual predictors of posttraumatic growth in 224 randomly selected breast cancer survivors. A series of hierarchical regression analyses found that age at diagnosis, marital status, employment, education, perceived intensity of disease, and active coping accounted for 34%, 35%, and 28% of the variance in growth in relationships with others, new possibilities, and appreciation for life. These findings suggest that a more comprehensive model of growth will be helpful in understanding the various factors that play a role in breast cancer survivors' perception of psychological and psychosocial growth.

Hampson, Sarah E.; Goldberg, Lewis R.; Vogt, Thomas M.; Dubanoski, Joan P.

doi: 10.1037/0278-6133.25.1.57pmid: 16448298

A life span health-behavior model was investigated in this longitudinal study of personality influences on health. Teachers assessed 963 elementary schoolchildren on traits that formed scales assessing the dimensions of the five-factor (Big Five) model of personality. Smoking, alcohol use, body mass index (BMI), and self-rated health were assessed 40 years later in midlife. Childhood personality traits were significantly associated with all 4 outcomes, and the effects were consistently larger for women than men. For men and women, childhood Conscientiousness was associated with less adult smoking and better adult self-rated health and, for women only, with lower adult BMI. Mediation analyses suggested that the effects of Conscientiousness on self-rated health were partially mediated by smoking and BMI. These findings add to the growing evidence that childhood personality traits predict adult health outcomes and are discussed in terms of future testing of the life span health-behavior model.

Honda, Keiko; Gorin, Sherri Sheinfeld

doi: 10.1037/0278-6133.25.1.65pmid: 16448299

Theory is little used in the prediction of physician cancer screening stage of change. Structural equation modeling was used to evaluate the theoretical predictors of stage of change to recommend colonoscopy among 235 urban physicians. Constructs from the theory of planned behavior, social-cognitive theory, and the transtheoretical model were systematically tested. As predicted, contextual factors, such as the physicians' ages, their race-ethnicities, patient race-ethnicity, and office-related barriers to preventive care were associated with stage of change through self-efficacy, normative beliefs, and negative behavioral beliefs. The findings demonstrate the relevance of these models to studying the behavior of physicians and support the development of interventions that are tailored to normative beliefs and specific physician cognitions for colonoscopy recommendation.

Simoni, Jane M.; Frick, Pamela A.; Huang, Bu

doi: 10.1037/0278-6133.25.1.74pmid: 16448300

Nonadherence in the management of chronic illness is a pervasive clinical challenge. Although researchers have identified multiple correlates of adherence, the field remains relatively atheoretical. The authors propose a cognitive-affective model of medication adherence based on social support theory and research. Structural equation modeling of longitudinal survey data from 136 mainly African American and Puerto Rican men and women with HIV/AIDS provided preliminary support for a modified model. Specifically, baseline data indicated social support was associated with less negative affect and greater spirituality, which, in turn, were associated with self-efficacy to adhere. Self-efficacy to adhere at baseline predicted self-reported adherence at 3 months, which predicted chart-extracted viral load at 6 months. The findings have relevance for theory building, intervention development, and clinical practice.