Health Psychology

Berg, Cynthia A.; Butner, Jonathan E.; Butler, Jorie M.; King, Pamela S.; Hughes, Amy E.; Wiebe, Deborah J.

doi: 10.1037/a0029427pmid: 22888825

Objective: The study examined (1) whether daily diabetes problems that adolescents experience were associated with parental persuasive strategies (e.g., persuading the adolescent to do more to manage diabetes), (2) whether this association was mediated through greater parental worry and lower confidence in adolescents’ abilities, and (3) how parental persuasive strategies may provide corrections for subsequent blood glucose control but reduce adolescent confidence for adolescents high in self-efficacy. Method: Adolescents with Type 1 diabetes (N = 180, ages 10.50–15.58 years) and their mothers (N = 176) and fathers (N = 139) completed diaries for 14 days reporting on problems experienced with diabetes, maternal and paternal use of persuasive strategies, and confidence in adolescents’ ability to manage diabetes. Parents reported their daily worry about diabetes, adolescents reported their general self-efficacy for diabetes management, and blood glucose was downloaded from glucometers. Results: Across reporters, multilevel modeling revealed that parents used more persuasive strategies on days when more diabetes problems were experienced. This association was mediated through parents’ greater worry and lower confidence in adolescents’ ability to manage diabetes. Lagged analyses revealed that adolescents’ perceptions of maternal persuasive strategies were associated with improvements in next-day blood glucose, but also with reductions in adolescents’ daily confidence for those high in self-efficacy. Conclusions: Parental persuasive strategies appear responsive to daily problems that adolescents experience in diabetes management. Mothers’ persuasive strategies may have the dual effects of correcting blood glucose levels but reducing the more self-efficacious adolescents’ confidence in their own ability to manage diabetes.

Fjeldsoe, Brianna S.; Miller, Yvette D.; Marshall, Alison L.

doi: 10.1037/a0027548pmid: 22612557

Objective: To explore whether improvements in physical activity following the MobileMums intervention were mediated by changes in Social Cognitive Theory (SCT) constructs targeted in the intervention (barrier self efficacy, goal setting skills, outcome expectancy, social support, and perceived environmental opportunity for exercise). This paper also examined if the mediating constructs differed between initial (baseline to 6 weeks) and overall (baseline to 13 weeks) changes in physical activity. Methods: Secondary analysis of data from a randomized controlled trial involving 88 postnatal women (<12 months postpartum). Participants were randomized to receive either the 12-week MobileMums intervention or a minimal-contact control condition. Physical activity and proposed mediators were assessed by self-report at baseline, 6 weeks, and 13 weeks. Walking for Exercise frequency was assessed using the Australian Women's Activity Survey and frequency of moderate-to-vigorous physical activity (MVPA) was assessed using a single-item question. Results: Initial improvements in goal-setting skills mediated the relationship between experimental condition and initial changes in MVPA, αβ (95% CI) = 0.23(0.01, 0.59), and Walking for Exercise, αβ (95% CI) = 0.34(0.06, 0.73). Initial improvements in barrier self efficacy mediated the relationship between experimental condition and initial change in MVPA, αβ (95% CI) = 0.36(0.12, 0.65), but not Walking for Exercise. None of the SCT outcomes significantly mediated the relationship between experimental condition and overall (baseline to 13 weeks) change in frequency of MVPA or Walking for Exercise. Conclusion: Future interventions with postnatal women using SCT should target barrier self-efficacy and goal setting skills in order to increase physical activity.

Khan, Cynthia M.; Stephens, Mary Ann Parris; Franks, Melissa M.; Rook, Karen S.; Salem, James K.

doi: 10.1037/a0028609pmid: 22708518

Objectives: Spouses may be involved in their partner's diabetes management by providing social support to affirm healthy behaviors and social control to modify health behaviors. Yet, investigations of the influence of spousal involvement on daily patient health behaviors are limited. In daily diaries, we investigated how spousal support and control independently and jointly influence patient physical activity and efficacy to engage in physical exercise on a daily basis. Methods: Older adults (age 55 and older) with Type 2 diabetes and their spouses (N = 70 couples) completed electronic diaries for seven consecutive days that assessed spouse-reported involvement and patient-reported minutes of physical exercise and efficacy to engage in future physical exercise. A subset of patients (N = 53) also wore an activity monitoring device on the wrist that provided a measure of energy expenditure. Results: Multilevel analyses indicated that on a daily basis, spousal support was positively associated with physical activity, whereas spousal control was either unrelated or linked to less physical activity. On days in which spouses provided high levels of both support and control, however, patients felt more efficacious that day about exercising tomorrow and exhibited an increase in energy expenditure on the next day. Conclusions: Findings suggest that spousal exercise support on its own or in conjunction with spousal exercise control may facilitate daily diabetes management through physical activity.

Appleton, Allison A.; Buka, Stephen L.; Loucks, Eric B.; Gilman, Stephen E.; Kubzansky, Laura D.

doi: 10.1037/a0030068pmid: 23815767

Objective: Recent work suggests effective emotion regulation may protect against risk of developing coronary heart disease (CHD), but the mechanisms remain unknown. Strategies for regulating emotions vary in how effectively they mitigate potentially toxic effects of stressful life experiences, and therefore may be differentially associated with CHD risk. In this study, we examined the emotion regulation strategies of reappraisal and suppression in relation to inflammation, a biological state associated with both stress and CHD. We hypothesized that suppression would be associated with elevated inflammation and reappraisal would be associated with lower levels of inflammation. Methods: We studied adult offspring (n = 379; mean age = 42.2 years) of Collaborative Perinatal Project participants, a national cohort of pregnant women enrolled in 1959–1966. Validated measures of two emotion regulation strategies were examined: reappraisal and suppression. Inflammation was measured as plasma C-reactive protein (CRP) levels. We fit multiple linear regression models predicting CRP while controlling for demographic, socioeconomic, and health factors, including depressive symptoms, measured across the life course. Results: A 1 standard deviation increase in reappraisal was associated with significantly lower CRP (b = −0.18, SE = 0.06, p < .01) controlling for demographics. This relation was somewhat attenuated in life course models, with adulthood body mass index partially explaining the association. A 1 standard deviation increase in suppression was associated with significantly higher CRP (b = 0.21, SE = 0.05, p < .001), and this association was not substantively attenuated with further covariate adjustment. Conclusion: Adaptive emotion regulation was associated with lower levels of inflammation and maladaptive emotion regulation was associated with higher levels of inflammation. If these associations are confirmed by prospective and experimental studies, such evidence may provide insight into novel targets for interventions to promote health and reduce cardiovascular risk.

Read, Jennifer P.; Wardell, Jeffrey D.; Vermont, Leah N.; Colder, Craig R.; Ouimette, Paige; White, Jacquelyn

doi: 10.1037/a0029085pmid: 22888814

Objective: College matriculation begins a period of transition that is marked by new freedoms and responsibilities and by increases in a variety of risky behaviors, including smoking. Trauma and posttraumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination. Method: Matriculating student smokers (N = 346) completed surveys in September (T1) and at 5 subsequent time points (T2–T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD). Results: Results showed that although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation. Conclusions: Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating and may ultimately prevent the adoption of daily smoking in later adulthood.

Jim, Heather S. L.; Jacobsen, Paul B.; Phillips, Kristin M.; Wenham, Robert M.; Roberts, William; Small, Brent J.

doi: 10.1037/a0031322pmid: 23437852

Objective: Recent research suggests that sleep disturbance, fatigue, and depressed mood form a symptom cluster in patients treated with chemotherapy. To date, however, no studies have examined lagged relationships among these symptoms during chemotherapy, a time when symptom variability is high. The aim of the current study was to examine lagged changes among daily symptoms during platinum-based chemotherapy. Method: Participants were 78 women with gynecologic cancer (mean age 63 years, SD = 11; 91% Caucasian, 97% non-Hispanic). Sleep disturbance was assessed via wrist actigraphy, whereas fatigue and depressed mood were assessed via daily diary in the week after participants’ first chemotherapy infusion. Latent change score models (LCS) were used to examine lagged relationships between symptom pairs. Results: High levels of sleep disturbance (i.e., minutes awake at night) were associated with earlier subsequent peaks in fatigue, and high levels of fatigue were associated with higher subsequent levels of depressed mood. Conclusions: These findings suggest that sleep disturbance, fatigue, and depressed mood occur in a cascade pattern during chemotherapy, in which increases in sleep disturbance contribute to fatigue, which, in turn, contributes to depressed mood. Interventions targeting symptoms early in the cascade, such as sleep disturbance, may provide benefits across multiple downstream symptoms.

Wichstrøm, Lars; von Soest, Tilmann; Kvalem, Ingela Lundin

doi: 10.1037/a0029465pmid: 22924445

Objective: To study the predictors of change in leisure time physical activity (LTPA) from adolescence to young adulthood. Method: A nationally representative sample of 3,251 Norwegian students between 12 and 19 years of age were initially surveyed, and follow-up surveys were conducted three times over a 13-year period. The initial response rate was 97%, and retention rates for the three follow-up sessions were 92%, 84%, and 82%, respectively. Four groups of predictors were assessed: sociodemographics, such as gender, age, parental socioeconomic status, pubertal status, and grades; previous LTPA, such as the amount of LTPA and sports club membership; athletic self-concept and depressive symptoms; and other health behaviors, such as smoking, dieting, and body mass. Autoregressive cross-lagged analyses were supplemented with latent growth-curve analyses. Results: Membership in a sports club and a positive athletic self-concept in adolescence predicted a high level of LTPA in adulthood, whereas smoking tobacco, high BMI, and depressive symptoms in adolescence predicted low levels of LTPA. Conclusions: Engaging adolescents in organized sports and enhancing adolescents’ athletic self-concept may increase the number of adults who are physically active. Preventive efforts to reduce tobacco consumption, obesity, and depression in adolescence may also contribute to an increase in adult LTPA.

Stavrakakis, N.; Oldehinkel, A. J.; Nederhof, E.; Oude Voshaar, R. C.; Verhulst, F. C.; Ormel, J.; de Jonge, P.

doi: 10.1037/a0030111pmid: 23088179

Objective: Physical activity is inversely associated with depression in adolescents, but the overall associations are fairly weak, suggesting individual differences in the strength of the associations. The aim of this study was to investigate whether plasticity genes modify the reciprocal prospective associations between physical activity and depressive symptoms found previously. Methods: In a prospective population-based study (N = 1,196), physical activity and depressive symptoms were assessed three times, around the ages of 11, 13.5, and 16. Structural Equation Modeling was used to examine reciprocal effects of physical activity and depressive symptoms over time. The plasticity genes examined were 5-HTTLPR, DRD2, DRD4, MAOA, TPH1, 5-HTR2A, COMT, and BDNF. A cumulative gene plasticity index consisting of three groups (low, intermediate, and high) according to the number of plasticity alleles carried by the adolescents was created. Using a multigroup approach, we examined whether the associations between physical activity and depressive symptoms differed between the three cumulative plasticity groups, as well as between the individual polymorphisms. Results: We found significant cross-sectional and cross-lagged paths from physical activity to depressive symptoms and vice versa. Neither the cumulative plasticity index nor the individual polymorphisms modified the strengths of these associations. Conclusion: Associations between adolescents’ physical activity and depressive symptoms are not modified by plasticity genes.

Chattillion, Elizabeth A.; Ceglowski, Jenni; Roepke, Susan K.; von Känel, Roland; Losada, Andres; Mills, Paul J.; Romero-Moreno, Rosa; Grant, Igor; Patterson, Thomas L.; Mausbach, Brent T.

doi: 10.1037/a0029412pmid: 22888824

Sheeran, Paschal; Harris, Peter; Vaughan, Jennifer; Oettingen, Gabriele; Gollwitzer, Peter M.

doi: 10.1037/a0029293pmid: 22888817

Objective: Fantasy realization theory (Oettingen, 2012) proposes that fantasizing about a desired future or dwelling upon negative reality rarely changes behavior whereas mentally contrasting fantasy with reality can be an effective behavior change technique. This is because mental contrasting energizes people to overcome obstacles that stand in the way of their desired future. The present study tested whether mental contrasting promotes rates of physical activity among overweight, middle-aged, and low-SES men. Method: A randomized controlled trial was conducted with members of an angling club in the north of England (N = 467). At baseline, participants completed a postal questionnaire that measured cognitions about physical activity. The intervention was embedded in the questionnaire for relevant participants. Behavior was followed up via telephone at 1 month and 7 months postbaseline. The key outcome measure was a validated, self-report measure of physical activity (Godin, Jobin & Bouillon, 1986) taken at all three time-points. Results: Longitudinal, explanatory, and intention-to-treat analyses each indicated that mental contrasting was effective in enhancing rates of physical activity. Mental contrasting also aided the translation of beliefs about the value and worth of physical activity (instrumental attitudes) into action. Conclusion: Mental contrasting appears to be an effective self-regulatory intervention for promoting physical activity and warrants further tests in health psychology.