Health Psychology

Williams, Adrian C.; Cundiff, Jenny M.; O’Neill, Riley M.; Garrison, Katie E.; Boylan, Jennifer Morozink

doi: 10.1037/hea0001493pmid: 40193437

Objective: Socioeconomic disparities in cardiovascular health are well established, but the role that stress and related physiological changes play in such disparities is still unclear. There is tentative evidence for a correlation between lower socioeconomic position and poorer cardiovascular response to stress, but observational designs do not allow for conclusions regarding causality. The current study presents results from a systematic review and meta-analysis on experimental manipulations of social rank and changes in cardiovascular reactivity and cortisol. Method: A meta-analysis was conducted (N = 2,005), including 25 studies (20 cardiovascular and five cortisol) and 71 effects (66 cardiovascular and five cortisol). Results: Primary analyses showed a nonsignificant effect of social rank manipulations on physiological outcomes (g = −0.04, p = .54, SE = 0.07, 95% confidence interval [CI] [−0.18, 0.09]). However, moderator analyses revealed that for studies that manipulated social rank based on socioeconomic factors (e.g., personal income, parental income/education), lower rank was significantly associated with heightened cardiovascular reactivity (g = −0.24, p = .006, SE = 0.09, 95% CI [−0.41, −0.07]). No significant effect was found for studies that used performance-based social rank manipulations (i.e., cognitive tasks such as word tracing and number counting). Conclusion: Results support the potentially causal influence of lower socioeconomic position on poorer cardiovascular health through elevated cardiovascular stress reactivity. We discuss the relevance of these findings to the role of psychophysiology for socioeconomic disparities in cardiovascular health.

Martire, Lynn M.; Reis, Harry T.; Felt, John M.; Huang, Yan

doi: 10.1037/hea0001481pmid: 40146607

Objective: This study investigates the divergent effects of daily relationship closeness on partners of individuals with chronic back pain (ICBPs). It examines whether greater daily closeness (emotional, behavioral, and cognitive) is associated with both increased partner distress due to ICBP’s pain and more positive marital interactions. Method: Data were drawn from a 30-day daily diary study involving 147 older couples, where one partner suffers from chronic back pain. Participants completed daily surveys on pain experiences, distress, and relationship closeness using tablet computers. Multivariate multilevel models tested the moderating effects of closeness on the association between ICBP’s pain-related experiences (severity, interference, and catastrophizing) and partner pain-related distress, while also assessing its impact on marital interaction quality. Results: As predicted, emotional closeness moderated the link between ICBP’s pain severity and partner distress, with stronger distress reported on days of high emotional closeness. Emotional closeness was also associated with more positive marital interactions that day. Contrary to expectation, there was a stronger effect of ICBP’s pain catastrophizing on partner distress on days of low behavioral closeness (i.e., less often working together on projects and engaging in outside interests together). Cognitive closeness showed a similar pattern, but the interaction was not statistically significant after inclusion of covariates. Conclusion: These findings illustrate a complex interplay between closeness and personal well-being in couples managing chronic illness and suggest the need for interventions that target both the benefits and potential costs of closeness.

Weber, Danielle M.; Lavner, Justin A.; Carter, Sierra; Ong, Mei-Ling; Lei, Man-Kit; Philibert, Robert; Beach, Steven R. H.

doi: 10.1037/hea0001495pmid: 40167560

Objective: Black Americans face disproportionate challenges related to substance use and the health impacts of substance use, including accelerated aging. Accordingly, interventions are needed to protect against the harmful effects of substance use on accelerated aging. The present study examined whether the Protecting Strong African American Families (ProSAAF) intervention, a relationship education program designed to promote strong relationships among Black families, moderated the association between substance use and accelerated aging among Black couples. Method: Black couples received either the ProSAAF intervention or a minimal-touch control intervention and provided deoxyribonucleic acid specimens for methylation-based biomarker measurements of alcohol use and cigarette smoking (Alcohol T scores and cg05575921, combined into a substance use composite) and accelerated aging (DNAm GrimAge) 6- and 9 years postintervention. Results: Participants receiving the ProSAAF intervention (relative to the control condition) experienced a significantly weaker association between substance use and accelerated aging. Among the participants who were in the same relationship as when they were initially randomized, the association between substance use and aging was significantly weaker in the ProSAAF condition than in the control condition for participants with lower relationship satisfaction preintervention; no differences emerged among those with higher satisfaction. Conclusions: ProSAAF mitigated some of the harmful effects of substance use on accelerated aging among Black couples, particularly among those with lower preintervention relationship satisfaction. These findings highlight the potential for relationship interventions to serve as sources of constructed resilience that promote healthier aging.

Emmer, Christine; Neumer, Anna; Kalter, Frank; Mata, Jutta

doi: 10.1037/hea0001496pmid: 40167559

Objective: Adolescence is a pivotal foundation for lifelong health and a phase vulnerable to the adverse effects of discrimination. We assessed the impact of perceived discrimination on adolescent well-being over 2 years and the mediating effects of protective (physical activity, nutrition, and sleep) and risky (substance use) health behaviors. Method: Adolescents (N = 9,957; Mage = 14.90 years) from the Children of Immigrants Longitudinal Survey in Four European Countries multinational panel (a longitudinal survey in four European countries) were examined across three waves. Direct and indirect relationships were analyzed using path models, adjusting for health behaviors, well-being, and control variables (age, gender, socioeconomic status, migration, and religion) assessed in Wave 1. Results: Adolescents reported the most discrimination instances within the school environment. Perceived discrimination at Wave 1 was significantly associated with decreased well-being at Wave 3 (β = −.04, p < .001) and decreased protective (physical activity, β = −.02; nutrition, β = −.04; sleep, β = −.04) and increased risky (substance use, β = .03) health behaviors at Wave 2. Nutrition and sleep mediated the relationship between perceived discrimination and well-being; no mediation was found for physical activity and substance use. Conclusions: Even in observational data with 1-year assessment intervals, detrimental long-term effects of perceived discrimination on adolescent well-being are apparent, mediated through changes in nutrition and sleep behaviors. These results extend previous research—predominantly focusing on substance use—showing that perceived discrimination also predicted fewer protective health behaviors. Adolescence represents a strategic window for addressing discrimination and promoting healthy behaviors and well-being to mitigate long-term health disparities.

Yi, Qian; Xiao, Wenhan; Hou, Leying; Li, Shuting; Sun, Weidi; Shan, Shiyi; Luo, Zeyu; Wang, Jingyi; Yang, Qian; Song, Peige

doi: 10.1037/hea0001500pmid: 40193434

Objectives: This study aimed to investigate the sex-specific associations between depressive symptom trajectories and the risk of Type 2 diabetes mellitus (T2DM). Method: This longitudinal study was based on the China Health and Retirement Longitudinal Study. Chinese residents aged ≥45 years with sufficient information were included in 2011–2015 and followed up in 2018. The sex-specific associations between depressive symptom trajectories and T2DM were calculated by Multivariable Cox frailty models. The population attributable fractions were used to quantify the risk of T2DM associated with trajectories of depressive symptoms. Results: Of the 2,949 males and 3,407 females included, 99 and 122 developed T2DM, respectively. We identified four depressive symptom trajectories in both sexes: maintained-low, decreasing, increasing, and maintained-high. Compared to those in maintained-low trajectory, females in all other trajectories had higher risks of T2DM (hazard ratios [HRs] ranged from 2.01 to 3.93). In comparison, only maintained-high (HR = 2.86, 95% confidence interval [CI] [1.42, 5.77]) and decreasing depressive symptom trajectories were associated with increased risk of T2DM (1.82, [1.10, 3.00]) in males. The T2DM risks attributable to maintained-high, increasing, and decreasing trajectories were 16.35%–23.75% in females. In males, maintained-high and decreasing trajectories accounted for 9.14% and 11.98% of T2DM risks. Conclusion: The sex-specific analysis revealed the trajectories with initially high levels of depressive symptoms were associated with T2DM in both sexes. Additionally, females exhibited an extra risk of T2DM associated with the increasing depressive symptoms trajectory. The findings necessitate monitoring and addressing depressive symptoms in preventing T2DM in both males and females.

Yang, Michelle Z.; Conner, Mark; Sheeran, Paschal

doi: 10.1037/hea0001507pmid: 40244985

Objective: This research explores the relationship between affect regulation and health behavior change through two studies. Study 1 tested whether difficulties with affect regulation are associated with lower health-related behavioral intentions. Study 2 introduces the Calibrate and Qualify Model to examine the role of cognitive reappraisal in predicting health-related intentions and behavior. We posit that reappraisal could impact health behaviors either by shaping the favorability of health-related attitudes, norms, and perceived behavioral control, thereby increasing intentions and subsequently behavior (Calibrate Route) or by serving as a moderator, such that healthful cognitions better predict intentions and behavior at high levels of cognitive reappraisal (Qualify Route). Method: Study 1 was a cross-sectional study of 15 health behaviors (N = 319) that measured reasoned action approach (RAA) variables and difficulties in emotion regulation. Study 2 was a 3-month longitudinal study (N = 807) of eight health-related behaviors that tested the Calibrate and Qualify Model predictions using measures of cognitive reappraisal, RAA variables, and habit. Results: Difficulties in emotion regulation, and limited access to affect regulation strategies in particular, predicted intentions to perform health behaviors (Study 1). Findings from Study 2 supported the Calibrate Route: cognitive reappraisal predicted intentions, and the reappraisal–intention relation was mediated by RAA variables. Supporting the Qualify Route, we observed a three-way interaction between habit, reappraisal, and intention, indicating that cognitive reappraisal combined with strong intentions attenuated the influence of habit on behavior. Conclusions: Our research suggests that affect regulation is an important consideration for predicting and understanding health behaviors.

Haydon, Marcie D.; Stanton, Annette L.; Hoyt, Michael A.; Bower, Julienne E.

doi: 10.1037/hea0001512pmid: 40323828

Background: Research on psychosocial interventions for survivors of adolescent and young adult (AYA) cancer is lacking, despite many experiencing adverse sequelae, including disruptions in psychosocial well-being. Method: The AYA Writing Project, an online randomized controlled trial, tested the efficacy of two prosocial writing interventions—peer helping and expressive writing + peer helping—against a cancer-specific fact-writing control. Young adults (18–39 years old) diagnosed with cancer at age 15–39 completed one 20-min writing activity each week for 4 weeks. Assessments were conducted at preintervention, postintervention, and 1-month postintervention. Analyses compared each intervention to the control condition using linear mixed models. The primary outcome was a change in well-being (i.e., total, hedonic, eudaimonic social, and eudaimonic psychological well-being) from preintervention to postintervention. Secondary outcomes included social support and depressive symptoms. Results: Participants (N = 201, Mage = 32.33 years, 76% female) were, on average, 5.07 years since diagnosis. Those assigned to the peer helping condition had significantly greater increases in eudaimonic psychological well-being (p = .038, f2 = 0.03) and ratings of social support (p = .043, f2 = 0.04) from preintervention to postintervention (but not 1 month later) relative to controls. Similar nonsignificant trends were observed when comparing the expressive writing + peer helping condition to controls (ps ≥ .051, f2s ≤ 0.04). For all other outcomes, no significant interaction effects emerged. Conclusion: Engaging in online peer helping via prosocial writing is an effective and accessible means of enhancing eudaimonic psychological well-being and social support among young adult survivors of AYA cancer.

doi: 10.1037/hea0001558pmid: 40720318

Landvatter, Joshua; Uchino, Bert N.; Rondina, Matthew

doi: 10.1037/hea0001501pmid: 40257908

Objective: The primary aim of this study was to determine if there is an existing link between attachment orientation and platelet activity. Second to this primary aim, was to explore moderating factors by which attachment may influence platelet activity, including trauma, age, and gender, given prior work. Method: Regression analyses were used for the primary aims. Consistent with prior work on psychosocial processes and biological pathways, age, gender, ethnicity, and measures of body mass index were controlled for. The main effects of attachment orientation on platelet levels were examined. Results: Both anxious (b = −0.25, SE = 0.07, p = .0004) and avoidant attachment (b = −0.27, SE = 0.08, p = .001) orientations were negatively related to levels of platelet activation when considering the standard control factors. Conclusion: Whereas no significant moderation was found, our regression analyses indicated reliable main effects of attachment orientation on platelet activity. Importantly, our novel findings are in the same direction of similar research, demonstrating that acute versus chronic states of anxiety or stress may have distinctly different influences on levels of platelet activity. This is consequential, as this has different implications for the onset, development, and treatment of diseases linked to chronic states of anxiety or stress, such as cardiovascular disease, cancer, and stroke.