Health Psychology

Kunzmann, Ute; Schilling, Oliver; Wrosch, Carsten; Siebert, Jelena S.; Katzorreck, Martin; Wahl, Hans-Werner; Gerstorf, Denis

doi: 10.1037/hea0000767pmid: 31135166

Objective: Our primary goal was to test the idea that the link between negative emotions and chronic physical illness will become stronger as individuals age and their resources become increasingly limited. Method: The data came from a 4-wave longitudinal study obtained from a sample of middle-aged (n = 500, mean age = 44.17, SD = .91) and older (n = 502, mean age = 62.87, SD = .89) adults who were observed for, on average, 13.59 years (SD = 7.32). Negative emotions were assessed by a subscale of the Zung depression scale and chronic illness severity was operationalized as a physician-rating. Results: Among older adults the association between changes in negative emotions and changes in physical illness status emerged over time (first retest interval: r = .02; p = .42; second interval: r = .11; p = .01; third interval: r = .22; p < .01), whereas such dynamics were not observed among middle-aged adults (first retest interval: r = .01; p = .77; second interval: r = .06; p = .12; third interval: r = −.01; p = .79). In addition, among older adults, negative emotions were generally higher and illness severity worse than in middle-aged adults. Negative emotions and chronic physical illness increased over time only in the older subsample. Conclusion: Research interested in linking negative emotions and poor physical health will benefit from a lifespan developmental perspective.

Bassett, Sarah M.; Schuette, Stephanie A.; O’Dwyer, Linda C.; Moskowitz, Judith T.

doi: 10.1037/hea0000778pmid: 31368717

Objective: This review aims to inform research and clinical care on the current state of knowledge on the relationship between positive affect and medication adherence. Method: Searches were carried out in PsycINFO, PubMed MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and Embase. There were no limits on study type, publication date, language, or participant demographics. Studies reporting a relationship between positive affect and medication adherence were eligible for inclusion if positive affect was measured prior to or concurrently with medication adherence. Results: Nine studies met inclusion criteria. All studies were prospective cohort or cross-sectional and examined positive affect and medication adherence in people living with HIV or cardiovascular conditions. The majority of results indicated positive associations between positive affect and medication adherence, with Cohen’s d effect sizes ranging from −0.40 to 1.27. Conclusions: Consistent with previous theoretical work, this systematic review provides evidence of a link between positive affect and improved medication adherence. Better measurement of both affect and medication adherence across chronic conditions is an important focus for future research and will inform targeted interventions to improve adherence and, ultimately, decrease the morbidity, mortality, and cost associated with suboptimal adherence in chronic physical conditions.

Bruine de Bruin, Wändi; Parker, Andrew M.; Galesic, Mirta; Vardavas, Raffaele

doi: 10.1037/hea0000771pmid: 31259597

Objective: Flu vaccinations are recommended for almost everyone, but uptake may vary because of perceived social norms. We aimed to examine the relationship between perceived social circle vaccine coverage (including family, friends, and acquaintances) and own vaccination behavior as well as potential mediators. Methods: In 2011, 357 participants from RAND’s American Life Panel reported perceived social circle vaccine coverage for the 2010–2011 flu season, own vaccination behavior for the 2009–2010 and 2010–2011 flu seasons, perceived flu risk without and with vaccination, and perceived vaccine safety. In 2012 and 2016, respectively, participants returned to report their own vaccination behavior for the 2011–2012 flu season (N = 338) and 2015–2016 flu season (N = 216). Results: Perceiving greater percentage of 2010–2011 social circle vaccine coverage was associated with a greater likelihood of getting vaccinated in the 2010–2011 flu season (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01, 1.04) and the subsequent 2011–2012 flu season (OR = 1.02, 95% CI = 1.01, 1.03) but not the 2015–2016 flu season (OR = 1.00, 95% CI = .99, 1.01), as seen in logistic regressions that controlled for demographics and 2009–2010 vaccination behavior. All significant relationships between social circle vaccine coverage and own vaccination behavior were mediated by perceived flu risk without vaccination. Conclusions: Perceived social circle vaccine coverage is associated with own vaccination behavior in the current and subsequent flu season, establishing behavior patterns that may persist into the future. People’s vaccination decisions may be informed by their perceptions of their peers’ beliefs and behaviors. We discuss intervention strategies for promoting vaccine uptake by counteracting negative and promoting positive perceived social norms.

Ayling, Kieran; Fairclough, Lucy; Buchanan, Heather; Wetherell, Mark A.; Vedhara, Kavita

doi: 10.1037/hea0000786pmid: 31380684

Objective: Positive mood on the day of vaccination has been associated with subsequent antibody responses to the influenza vaccine in older adults. The primary aim of this trial was to examine whether a brief intervention was able to enhance positive mood at the time of vaccination in a clinical context. Secondary aims included exploratory analyses of the effects of the intervention on nonspecific and influenza-specific immunity. Method: One hundred three older adults (65–85 years) participated in a 2-arm, parallel, single-blind, randomized controlled trial. Participants viewed either a 15-min video package designed to induce positive mood or a matched neutral control video, immediately prior to receiving a standard dose quadrivalent influenza vaccination. State affect and secretory immunoglobulin A levels were assessed immediately prior to, and following, the interventions. Antigen-specific immunoglobulin G responses to the vaccination were assessed at 4 and 16 weeks postvaccination. Results: The positive mood intervention resulted in significant improvements in state positive affect, compared with the neutral control. Secretory immunoglobulin A levels significantly increased across both groups. Antigen-specific immunoglobulin G responses to influenza vaccination were not statistically significantly different between groups, although point estimates of effect size favored participants who viewed the positive mood intervention for most strains at both 4 and 16 weeks postvaccination. Conclusions: A 15-min intervention can improve positive mood in older adults prior to vaccination. Future trials should examine whether enhancing mood at the time of vaccination could enhance the effectiveness of influenza vaccination on patients and benefit health services.

Davis, Kelly Cue

doi: 10.1037/hea0000779pmid: 31259595

Objective: The purpose of this study was to investigate the rates, predictors, and associated sexual risk indices of young men’s nonconsensual condom removal (also known as stealthing). Methods: Participants were 626 male inconsistent condom users aged 21–30 years recruited from an urban area in the Pacific Northwest. Participants completed survey measures assessing sexual aggression history, sexual aggression-related attitudes, sexually transmitted infection history, unplanned pregnancies, and nonconsensual condom removal experiences. Results: Almost 10% of the participants (n = 61) reported engaging in nonconsensual condom removal since the age of 14 years, with an average of 3.62 times (SD = 3.87) and range of 1–21 times (maximum possible). After controlling for condom use self-efficacy, men with greater hostility toward women (odds ratio = 1.47) and more severe sexual aggression history (odds ratio = 1.06) had significantly higher odds of engaging in nonconsensual condom removal behavior. χ2 analyses demonstrated that men who had a history of nonconsensual condom removal were significantly more likely to have had a sexually transmitted infection diagnosis (29.5% vs. 15.1%) or have had a partner who experienced an unplanned pregnancy (46.7% vs. 25.8%). Conclusions: Nonconsensual condom removal, which involves elements of both sexual risk and sexual aggression, confers multiple sexual risks to its recipients, thus meriting increased clinical and research attention.

Foley, Jacklyn D.; Vanable, Peter A.; Brown, Larry K.; Carey, Michael P.; DiClemente, Ralph J.; Romer, Daniel; Valois, Robert F.

doi: 10.1037/hea0000780pmid: 31380687

Objective: Understanding individual level factors associated with sexual risk behaviors among African-American adolescents remains an important public health priority. The current secondary data analysis examined the longitudinal association between a baseline assessment of depressive symptoms and sexual risk behaviors reported 6 months later; the purpose was to determine whether the association of depressive symptoms to risky sex varies as a function of gender. A secondary aim was to examine self-efficacy for sex refusal and condom use assessed at a 3-month follow-up as mediators of the depressive symptoms-sexual risk relationship. Methods: The sample consisted of 782 sexually active African-American adolescents (Mage = 15.3 years, SD = 1.08; 54% female) recruited to participate in a sexual health intervention trial. Data analyses focused on vaginal sex, and outcomes included: (a) sexual activity with 2 or more partners in the previous 3 months; (b) the relative frequency of condom use in the previous 3 months; (c) noncondom use at last occasion of sex; and (d) positive sexually transmitted infection (STI) screening. Results: Depressive symptoms predicted sex with 2 more partners for female participants, but no other risk markers for the sample as a whole. However, there was a significant indirect effect of depressive symptoms on condomless sex via decreased condom use self-efficacy for both male and female adolescents. Conclusions: These findings have important implications for HIV/STI prevention, in which behavioral interventions may benefit from modules that include a focus on the influence of mood on self-efficacy for safer sex practices.

Carter, Sierra E.; Ong, Mei Ling; Simons, Ronald L.; Gibbons, Frederick X.; Lei, Man Kit; Beach, Steven R. H.

doi: 10.1037/hea0000788pmid: 31343220

Objective: This study examined the role of depressive symptoms in mediating the relationship between early life experiences of racial discrimination and accelerated aging in adulthood for African Americans (i.e., prediction over a 19-year period, from ages 10 to 29) after adjusting for gender and health behaviors. Method: Longitudinal self-report data over 7 waves of data collection from the Family and Community Health Study were utilized. The sample included 368 African Americans with usable gene expression data to compute accelerated aging, as well as complete data on all self-report variables including racial discrimination (Schedule of Racist Events) and depression (Diagnostic Interview Schedule for Children—Version 4). Blood was collected by antecubital blood draws from participants at age 29. The proposed model was tested by path analysis. Results: Findings revealed that high discrimination at ages 10–15 was associated with depression at ages 20–29 (β = .19, p = .001), controlling for depression at ages 10–15, which, in turn, was related to accelerated cellular-level aging (β = .11, p = .048) after controlling for gender, alcohol consumption, and cigarette use. The indirect effect of racial discrimination on aging through depression at ages 20–29 was significant (β = .021, 95% confidence interval [.001, .057]), accounting for 32.3% of the total variance. Conclusion: These findings support research conceptualizations that early life stress due to racial discrimination lead to sustained negative affective states continuing into young adulthood that confer risk for accelerated aging and possibly premature disease and mortality in African Americans. These findings advance knowledge of potential underlying mechanisms that influence racial health disparities.

Hackett, Ruth A.; Steptoe, Andrew; Jackson, Sarah E.

doi: 10.1037/hea0000796pmid: 31497985

Objective: The purpose of this study was to examine cross-sectional and prospective associations between perceived sex discrimination and health and well-being in a sample from the United Kingdom. Method: Data were from 2,956 women aged ≥16 years who participated in the U.K. Household Longitudinal Study. Perceived discrimination was reported in 2009–2010. Psychological distress, mental functioning, life satisfaction, and self-rated health were assessed in 2009–2010 and 2013–2014. Depression was assessed in 2009 and 2010. Linear and logistic regression analyses adjusted for age, income, education, and ethnicity. Prospective analyses adjusted for baseline well-being. Results: Perceived sex discrimination was reported by 576 (19.5%) participants. Younger, wealthier, better educated, White women reported more discrimination (p < .001). Cross-sectionally, perceived discrimination was associated with increased depression (odds ratio [OR] = 3.16, 95% confidence interval [CI; 2.10, 4.79]) psychological distress (B = 1.26, 95% CI [0.95, 1.56]), poorer mental functioning (B = −5.39, 95% CI [−6.33, −4.46]), lower life satisfaction (B = −0.52, 95% CI [−0.69, −0.36]), and greater odds of poor self-rated health (OR = 1.89, 95% CI [1.47, 2.41]). Prospectively, perceived sex discrimination was associated with increased psychological distress (B = 0.66, 95% CI [0.07, 1.24]), poorer mental functioning (B = −1.37, 95% CI [−2.71, –0.03]), and lower life satisfaction (B = −0.32, 95% CI [−0.58, −0.05]) over 4-year follow-up. Conclusions: Women who perceive that they have been discriminated against based on their sex report poorer mental health and well-being than those who do not perceive discrimination. These results provide cross-sectional and prospective evidence of associations between perceived sex discrimination and mental well-being outcomes in U.K. women.

Tomfohr-Madsen, Lianne; Cameron, Emily E.; Dunkel Schetter, Christine; Campbell, Tavis; O’Beirne, Maeve; Letourneau, Nicole; Giesbrecht, Gerald F.

doi: 10.1037/hea0000792pmid: 31380685

Objective: Preterm birth (PTB) is a prevalent public health concern. Pregnancy anxiety, poor sleep quality, and short sleep duration have been associated with an increased risk of PTB. Theoretically, sleep variables could moderate the strength of the relationship between pregnancy anxiety and PTB; investigating this question was the primary aim of this study. Method: The sample consisted of 290 pregnant women who were assessed at 2 time points in pregnancy: Time 1 (<22 weeks gestational age [GA]; MGA = 15.04, SD = 3.55) and Time 2 (32 weeks GA; MGA = 32.44, SD = 0.99). Pregnancy anxiety was assessed with the Pregnancy-Related Anxiety Scale, sleep quality was assessed by the Pittsburgh Sleep Quality Index, and sleep duration was assessed via actigraphy. Data on gestational age at birth were obtained from the electronic medical record. Results: After adjustment for relevant covariates, higher levels of pregnancy anxiety were associated with shorter gestational length and an increased risk of PTB. There were no direct associations between sleep quality or sleep duration and gestational length or PTB. Pregnancy anxiety interacted with sleep duration such that pregnancy anxiety was significantly associated with shorter gestational length and PTB only when women had relatively shorter sleep duration (approximately <8.3 hr). Conclusions: This study reveals new evidence of an interaction between pregnancy anxiety and sleep duration in the prediction of the timing of delivery. The findings point to avenues to better understand and potentially ameliorate risk for PTB.

Goodhines, Patricia A.; Gellis, Les A.; Ansell, Emily B.; Park, Aesoon

doi: 10.1037/hea0000765pmid: 31169378

Objective: One in 5 college students use substances such as cannabis and/or alcohol to help sleep. Despite this high prevalence of sleep aid use, there remains a lack of research on the potential day-to-day sleep- and substance-related consequences. The current study examined associations of cannabis and alcohol sleep aid use with subsequent sleep and substance use consequences among college students. Method: Of a baseline sample of 217 college students endorsing past-month cannabis and/or alcohol use (1% cannabis only, 42% alcohol only, 58% both), 83 students endorsing past-month cannabis and/or alcohol use for sleep aid (Mage = 19.33 [SD = 1.11], 30% male, 72% White) completed online questionnaires for 14 consecutive days to report daily sleep, substance use, and negative substance consequences. Results: Multilevel models demonstrated that nights of cannabis sleep aid use predicted longer same-night sleep duration, shorter same-night wake time after sleep onset, and greater next-day daytime fatigue within person, after controlling for daily cannabis frequency. Alcohol sleep aid use was not associated with sleep-related outcomes or negative drinking consequences after controlling for daily alcohol quantity; these null results may be due to a low frequency of alcohol sleep aid use (1% of observations) over 14 days of assessment. Conclusions: Results highlight daytime fatigue as a potential adverse short-term outcome of cannabis sleep aid use, despite its proximal sleep-related benefits.