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Tani Y, Fujiwara T, Kondo K. Associations of Cooking Skill with Social Relationships and Social Capital among Older Men and Women in Japan: Results from the JAGES. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054633. [PMID: 36901644 PMCID: PMC10002414 DOI: 10.3390/ijerph20054633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/03/2023] [Accepted: 03/05/2023] [Indexed: 05/13/2023]
Abstract
The health benefits of social relationships and social capital are well known. However, little research has examined the determinants of social relationships and social capital. We examined whether cooking skill was associated with social relationships and social capital in older Japanese people. We used 2016 Japan Gerontological Evaluation Study data on a population-based sample of men and women aged ≥ 65 years (n = 21,061). Cooking skill was assessed using a scale with good validity. Social relationships were evaluated by assessing neighborhood ties, frequency and number of meetings with friends, and frequent meals with friends. Individual-level social capital was evaluated by assessing civic participation, social cohesion, and reciprocity. Among women, high-level cooking skill was positively associated with all components of social relationships and social capital. Women with high-level cooking skill were 2.27 times (95% CI: 1.77-2.91) more likely to have high levels of neighborhood ties and 1.65 (95% CI: 1.20-2.27) times more likely to eat with friends, compared with those with middle/low-level cooking skill. Cooking skills explained 26.2% of the gender difference in social relationships. Improving cooking skills may be key to boosting social relationships and social capital, which would prevent social isolation.
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Affiliation(s)
- Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
- Correspondence: ; Tel.: +81-3-5803-5189
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi 260-8672, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430 Morikoka-cho, Obu-shi 474-8511, Japan
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Jones EJ, Ayling K, Wiley CR, Geraghty AW, Greer AL, Holt-Lunstad J, Prather AA, Schreier HM, Silver RC, Sneed RS, Marsland AL, Pressman SD, Vedhara K. Psychology Meets Biology in COVID-19: What We Know and Why It Matters for Public Health. POLICY INSIGHTS FROM THE BEHAVIORAL AND BRAIN SCIENCES 2023; 10:33-40. [PMID: 36942265 PMCID: PMC10018248 DOI: 10.1177/23727322221145308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Psychosocial factors are related to immune, viral, and vaccination outcomes. Yet, this knowledge has been poorly represented in public health initiatives during the COVID-19 pandemic. This review provides an overview of biopsychosocial links relevant to COVID-19 outcomes by describing seminal evidence about these associations known prepandemic as well as contemporary research conducted during the pandemic. This focuses on the negative impact of the pandemic on psychosocial health and how this in turn has likely consequences for critically relevant viral and vaccination outcomes. We end by looking forward, highlighting the potential of psychosocial interventions that could be leveraged to support all people in navigating a postpandemic world and how a biopsychosocial approach to health could be incorporated into public health responses to future pandemics.
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Affiliation(s)
- Emily J. Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kieran Ayling
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Cameron R. Wiley
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Adam W.A. Geraghty
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Amy L. Greer
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | | | - Aric A. Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Hannah M.C. Schreier
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Roxane Cohen Silver
- Department of Psychological Science, Department of Medicine, Program in Public Health, University of California, Irvine, Irvine, California, USA
| | - Rodlescia S. Sneed
- Institute of Gerontology and Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sarah D. Pressman
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Kavita Vedhara
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
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Bloom RF, Siedlecki KL. Testing the Reserve Capacity Model: Does Race Moderate the Relationship Between Negative Emotions and Neurocognition? Arch Clin Neuropsychol 2023; 38:213-223. [PMID: 36062422 PMCID: PMC9940113 DOI: 10.1093/arclin/acac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To test whether race moderates the relationship between negative emotions and neurocognition by applying the reserve capacity model within a large sample that spans adulthood. METHOD The study sample (N = 1,020) consisted of community-dwelling adults between 18 and 84 years of age who were drawn from the Virginia Cognitive Aging Project. Demographic variables were used to match a sample of Black participants to a sample of White participants. Race was examined as a moderator of the relationship between negative emotions (i.e., depressive symptoms, trait anxiety, and the negative affect subscale from the Positive and Negative Affect Schedule) and neurocognitive variables (episodic memory, reasoning, spatial visualization, and processing speed) with multiple-group structural equation modeling. RESULTS After accounting for sociodemographic variables, depressive symptoms were negatively associated with processing speed in both groups, and with worse reasoning in the White subsample. Negative affect was associated with lower reasoning performance in both groups and with lower spatial visualization in the White subsample. Trait anxiety was not significantly associated with the neurocognitive constructs in either group. Multigroup structural equation models showed that the magnitudes of the associations were not different between the Black and White subsamples. Thus, race did not moderate the relationships between depressive symptoms, trait anxiety, and negative affect with neurocognition. CONCLUSIONS Negative emotions are associated with lower performance on different neurocognitive tasks, but race does not moderate these relationships. Future research should examine perceived discrimination or other psychosocial variables when examining the relationships among negative emotions and neurocognition.
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Affiliation(s)
- Rachel F Bloom
- Department of Psychology, Fordham University, Bronx, NY10458, USA
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Lai ETC, Ho SC, Woo J. Social isolation, socioeconomic status, and development of functional impairments in Chinese older adults aged 70 years and over: a cohort study. Aging Clin Exp Res 2023; 35:155-165. [PMID: 36273110 PMCID: PMC9589608 DOI: 10.1007/s40520-022-02259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/14/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Social isolation in older people has been increasingly regarded as a public health issue in the face of rapid population ageing. It is not clear whether social isolation mediates the relationship between socioeconomic status and functional impairment. METHODS We used data from a cohort of Chinese older people aged 70 or older living in community (n = 1590). Socioeconomic status (SES) was operationalised as highest education attainment, monthly income at baseline and longest held occupation in lifetime. Functional abilities were measured using Barthel's Index for activities of daily living (ADL) measured at 18 and 36 months of follow-up, from which impairment was defined as score ≤ 19. Social isolation was measured by six attributes, such as marital status, living alone, and social contact with others. A score of ≥ 3 was defined as being in social isolation. Causal mediation analysis using natural effect models was used to assess mediation by social isolation. RESULTS We found that lower monthly income at baseline was related to higher risk of social isolation [relative risk comparing lowest to highest income (RR) = 1.52, 95% confidence interval (95% CI) 1.01-2.28]. Social gradient of ADL impairment was not clearly present. The evidence for the mediating role of social isolation was not clear. CONCLUSIONS Older people with low SES, particularly those with lower income, were at greater risk of social isolation. Policymakers should strive to improve the current community services and pension scheme to mitigate the situation of social isolation in older people in Hong Kong.
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Affiliation(s)
- Eric Tsz Chun Lai
- Institute of Health Equity, The Chinese University of Hong Kong, Suite 602, 6/F, Yasumoto International Academic Park, Shatin, New Territories, Hong Kong
| | - Suzanne C Ho
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jean Woo
- Institute of Health Equity, The Chinese University of Hong Kong, Suite 602, 6/F, Yasumoto International Academic Park, Shatin, New Territories, Hong Kong.
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
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Arpawong TE, Sakuma KLK, Espinoza L, Huh J. Longitudinal Examination of an Ethnic Paradox of Stress and Mental Health in Older Black and Latinx Adults. Clin Gerontol 2023; 46:27-46. [PMID: 35320059 PMCID: PMC9500116 DOI: 10.1080/07317115.2022.2056102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To explain the ethnic paradox of mental health in aging, we evaluated whether Black and Latinx older adults experience (1) fewer depressive symptoms (DepSx), but more physical problems, and (2) greater psychological resilience as a result of life stressors than White older adults. METHODS DepSx, physical health, and recent stress were obtained biennially from 25,893 older adults (77% White, 15% Black, 9% Latinx) in the U.S. Health and Retirement Study, across 16 years. Psychological resilience, lifetime stress, and discrimination experiences were available for 13,655 individuals. We conducted mixed-effects and linear regression analyses. RESULTS For Blacks and Latinxs, experiencing more-than-usual stress events was associated with less increase in DepSx compared to Whites, although on average Blacks and Latinxs experience more DepSx. Black adults showed worse physical health than White adults and weaker effects of stress on psychological resilience despite experiencing more stress of all types. Findings were mixed for Latinxs. CONCLUSIONS Studying effects of time-varying stress on changes in health and multiple stressors on psychological resilience by race/ethnicity elucidates mechanisms for later-age health disparities. CLINICAL IMPLICATIONS Cross-sectional evaluations of stress and psychological health in a clinical setting may provide incomplete appraisals of health risks for Black and Latinx older Americans.
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Affiliation(s)
- Thalida Em Arpawong
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kari-Lyn K. Sakuma
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Lilia Espinoza
- Department of Public Health, California State University, Fullerton, CA, USA
| | - Jimi Huh
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
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Perez AD, Dufault SM, Spears EC, Chae DH, Woods-Giscombe CL, Allen AM. Superwoman Schema and John Henryism among African American women: An intersectional perspective on coping with racism. Soc Sci Med 2023; 316:115070. [PMID: 35690497 DOI: 10.1016/j.socscimed.2022.115070] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/13/2022] [Accepted: 05/22/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE John Henryism and Superwoman Schema (SWS) are dispositional characteristics adopted to overcome the challenges of chronic psychosocial stress, and have particular salience for African American women. Both show protective and harmful effects on health and share conceptual similarities and distinctions, yet there is no empirical evidence of the potential overlap resulting in uncertainty about the unique roles they may each play concerning the health of African American women. OBJECTIVE We examined: 1) whether and to what extent John Henryism and SWS represent similar or distinct constructs relevant to the unique sociohistorical and sociopolitical position of African American women, and 2) whether the two differentially predict health outcomes. METHODS Data are from a purposive and socioeconomically diverse sample of 208 African American women in the San Francisco Bay Area. First, we conducted a progressive series of tests to systematically examine the conceptual and empirical overlap between John Henryism and SWS: correlation analysis, exploratory factor analysis (EFA), principal component analysis and k-modes cluster analysis. Next, we used multivariable regression to examine associations with psychological distress and hypertension. RESULTS John Henryism and SWS were moderately correlated with one another (rs = 0.30-0.48). In both EFA and cluster analyses, John Henryism items were distinct from SWS subscale items. For SWS, feeling an obligation to present an image of strength and an obligation to help others predicted higher odds of hypertension (p < 0.05); having an intense motivation to succeed predicted lower odds (p = 0.048). John Henryism did not predict hypertension. Feeling an obligation to help others and an obligation to suppress emotions predicted lower levels of psychological distress (p < 0.05) whereas John Henryism predicted higher distress (p = 0.002). CONCLUSIONS We discuss the implications of these findings for the measurement of culturally specific phenomena and their role in contributing to the unequal burden of ill health among African American women.
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Affiliation(s)
- Amanda D Perez
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA.
| | - Suzanne M Dufault
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA
| | - Erica C Spears
- Louisiana Public Health Institute, 400 Poydras St., Suite 1250, New Orleans, LA 70130, USA
| | - David H Chae
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St, New Orleans, LA, 70112, USA
| | - Cheryl L Woods-Giscombe
- School of Nursing, The University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599-7460, USA
| | - Amani M Allen
- Divisions of Community Health Sciences and Epidemiology, University of California Berkeley School of Public Health, 2121 Berkeley Way #5302, Berkeley, CA, 94720-7360, USA
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Choi SL, Lee YG. Financial hardship and change in emotional well-being before to during COVID-19 pandemic among middle-aged and older Americans: Moderating effects of internal coping resources. Soc Sci Med 2023; 317:115572. [PMID: 36473337 PMCID: PMC9683862 DOI: 10.1016/j.socscimed.2022.115572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate associations between financial hardship and change in emotional well-being-positive and negative affect-before to during the COVID-19 pandemic among middle-aged and older Americans and to examine the extent to which associations were moderated by internal coping resources-dispositional mastery and optimism. METHOD Data derived from the Leave-Behind Questionnaire in the 2016 and 2020 waves of the Health and Retirement Study, a nationally representative longitudinal survey of U.S. adults aged 51 and older (N = 1312). We estimated multivariate ordinary least squares regression models with interaction terms to evaluate prospectively the benefits of mastery and optimism as internal coping resources for middle-aged and older adults. RESULTS Dispositional mastery moderated the effects of financial hardship on changes in negative and positive affect, respectively, before to during the COVID-19 pandemic; however, optimism did not significantly moderate the effects of financial hardship on change in negative and positive affect before to during the COVID-19 pandemic. CONCLUSIONS Our findings have implications for interventions aimed at improving middle-aged and older adults' emotional well-being by promoting internal coping resources. Specifically, interventions should focus on financial hardship and mastery for vulnerable middle-aged and older adults in the context of public health crises.
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Affiliation(s)
- Shinae L. Choi
- The University of Alabama, 304 Adams Hall, Box 870158, Tuscaloosa, AL, 35487, USA,Center for Innovation in Social Science, Boston University, 704 Commonwealth Ave, Boston, MA, 02215, USA,Corresponding author. Department of Consumer Sciences, College of Human Environmental Sciences, The University of Alabama, 304 Adams Hall, Box 870158, Tuscaloosa, AL, 35487
| | - Yoon G. Lee
- Utah State University, 2905 Old Main Hill, Logan, UT, 84322, USA
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Tami-Maury I, Klaff R, Hussin A, Smith NG, Chang S, McNeill L, Reitzel LR, Shete S, Abroms LC. A Text-Based Smoking Cessation Intervention for Sexual and Gender Minority Groups: Protocol for a Feasibility Trial. JMIR Res Protoc 2022; 11:e42553. [PMID: 36485022 PMCID: PMC9789491 DOI: 10.2196/42553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Smoking among sexual and gender minority (SGM) groups, which include lesbian, gay, bisexual, transgender, and queer individuals, has been reported to be highly prevalent. This is attributed to several factors, including minority-specific stress and targeted tobacco marketing. Therefore, this population is at an increased risk for tobacco-related diseases. SMS text messaging programs have been found to be effective for smoking cessation and appeal to traditionally hard-to-reach populations over other interventions. It has also been suggested that targeted and tailored interventions could be more effective among SGM smokers because they can be designed to assure a safe, validating health care environment that enhances receptivity to cessation. OBJECTIVE The aim of this study is to develop SmokefreeSGM, a text-based smoking cessation program tailored to and tested among SGM smokers. METHODS The study consists of three phases, culminating in a feasibility trial. In Phase 1, our research team will collaborate with a Community Advisory Board to develop and pretest the design of SmokefreeSGM. In Phase 2, the tailored text messaging program will be beta tested among 16 SGM smokers. Our research team will use a mixed-methods approach to collect and analyze data from participants who will inform the refinement of SmokefreeSGM. In Phase 3, a feasibility trial will be conducted among 80 SGM smokers either enrolled in SmokefreeSGM or SmokefreeTXT, the original text-based program developed by the National Cancer Institute for the general population. Our research team will examine recruitment, retention, and smoking abstinence rates at 1-, 3-, and 6-month follow-up. Additionally, a qualitative interview will be conducted among 32 participants to evaluate the feasibility and acceptability of the programs (SmokefreeSGM and SmokefreeTXT). RESULTS This study received approval from The University of Texas Health Science Center at Houston Committee for the Protection of Human Subjects to begin research on August 21, 2020. Recruitment for the beta testing of SmokefreeSGM (Phase 2) began in January 2022. We estimate that the feasibility trial (Phase 3) will begin in September 2022 and that results will be available in December 2023. CONCLUSIONS Findings from this research effort will help reduce tobacco-related health disparities among SGM smokers by determining the feasibility and acceptability of SmokefreeSGM, an SGM-tailored smoking cessation intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05029362; https://clinicaltrials.gov/ct2/show/NCT05029362. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42553.
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Affiliation(s)
- Irene Tami-Maury
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Rebecca Klaff
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Allison Hussin
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Nathan Grant Smith
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, United States
| | - Shine Chang
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Lorna McNeill
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Lorraine R Reitzel
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Sanjay Shete
- MD Anderson Cancer Center, The University of Texas, Houston, TX, United States
| | - Lorien C Abroms
- Milken Institute of Public Health, The George Washington University, Washington, DC, United States
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Wang R, Lin X, Wang L. The paradoxical effects of social class on career adaptability: The role of intolerance of uncertainty. Front Psychol 2022; 13:1064603. [PMID: 36562049 PMCID: PMC9766956 DOI: 10.3389/fpsyg.2022.1064603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction As a growth background factor, family social class has far-reaching effects on youth career development. However, we have limited understanding of the role and functional mechanisms of social class in career adaptability. Based on the social cognitive theory of social class, we examine the mediating role of intolerance of uncertainty in the relationship between youths' subjective social class and career adaptability. We also explore the moderating influences of self-esteem. Methods Data were collected from a sample consisting of 712 undergraduates (63.2% female) in China. Results Results show that subjective social class positively impacts career adaptability via prospective anxiety, and negatively impacts career adaptability via inhibitory anxiety. The intensity of these indirect relationships is contingent on youths' self-esteem. Discussion Our study illustrates the complex and paradoxical effects of social class on career adaptability and has important theoretical and practical implications. This study expands the theoretical perspective by bringing in the social cognitive theory of social class, provides novel insight into the complex interaction between individuals and the environment in youth career development, and should provide inspiration for the design of career intervention programs.
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Affiliation(s)
- Ruimeng Wang
- School of Labor and Human Resources, Renmin University of China, Beijing, China,*Correspondence: Ruimeng Wang,
| | - Xinqi Lin
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Le Wang
- Department of Physical Education, Shandong University of Traditional Chinese Medicine, Jinan, China
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Garey L, Zvolensky MJ, Gallagher MW, Vujanovic A, Kendzor DE, Stephens L, Cheney MK, Cole AB, Kezbers K, Matoska CT, Robison J, Montgomery A, Zappi CV, Businelle MS. A Smartphone-Based Intervention for Anxiety and Depression in Racially and Ethnically Diverse Adults (EASE): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40713. [PMID: 36409958 PMCID: PMC9728024 DOI: 10.2196/40713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Clear health disparities have emerged in the rates of COVID-19 exposure, hospitalization, and death among Black, Hispanic, and American Indian (BHAI) individuals, relative to non-Hispanic White (NHW) individuals. BHAI populations have been disproportionately affected by lower behavioral health access and heightened negative mental health outcomes during the pandemic. OBJECTIVE This project directly addresses health disparities in access to behavioral health care during the COVID-19 pandemic among BHAI populations via an adaptation of the established, initially validated, low-cost, mobile app Easing Anxiety Sensitivity for Everyone (EASE) among individuals with symptoms of elevated anxiety or depression or both. METHODS The EASE trial is a 2-arm, prospective, randomized, blinded-assessor study with intention-to-treat analysis. Participants (N=800; n=200, 25%, Black; n=200, 25%, Hispanic; n=200, 25%, American Indian; and n=200, 25%, NHW) are randomized to receive either EASE or an active comparison condition for anxiety and depression. Participants compete an online prescreener, an enrollment call to provide informed consent, a baseline survey, a 6-month intervention period, and 3- and 6-month postbaseline assessments. Select participants also complete a 3- and 6-month postbaseline qualitative interview via phone or an online platform (eg, Zoom). Participants complete 2 scheduled daily ecological momentary assessments (EMAs) during the 6-month study period. These twice-daily EMAs guide a just-in-time approach to immediate, personalized behavioral health care. RESULTS Outcomes include reductions in anxiety and depressive symptoms and functional impairment at 3 and 6 months postrandomization. We also will examine putative mechanisms (eg, anxiety sensitivity [AS] and COVID-19-specific stress and fear) of the intervention effects. Further, as treatment effects may differ across sociocultural factors, perceived discrimination, social support, and socioeconomic status (SES) will be evaluated as potential moderators of treatment effects on the primary outcomes. Process evaluation using data collected during the study, as well as individual interviews with participants, will complement quantitative data. CONCLUSIONS Data from this efficacy trial will determine whether EASE successfully improves symptoms of anxiety and depression and whether these improvements outperform an active comparison control app. If successful, findings from this study have the potential to decrease anxiety and depression symptoms among vulnerable populations determined to be most at risk of exacerbated, long-lasting negative health sequelae. Data from this study may be used to support an implementation and dissemination trial of EASE within real-world behavioral health and social service settings. TRIAL REGISTRATION ClinicalTrials.gov NCT05074693; https://clinicaltrials.gov/ct2/show/NCT05074693. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40713.
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Affiliation(s)
- Lorra Garey
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael J Zvolensky
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
- Department of Behavioral Science, MD Anderson Cancer Center, University of Texas, Houston, TX, United States
| | - Matthew W Gallagher
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, United States
| | - Anka Vujanovic
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| | - Lancer Stephens
- College of Public Health, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
- Oklahoma Shared Clinical and Translational Research Resources, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Ashley B Cole
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Krista Kezbers
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Cameron T Matoska
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Jillian Robison
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Audrey Montgomery
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
| | - Christopher V Zappi
- HEALTH Institute, University of Houston, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael S Businelle
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, United States
- Department of Family and Preventive Medicine, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, United States
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Kaklauskas A, Abraham A, Ubarte I, Kliukas R, Luksaite V, Binkyte-Veliene A, Vetloviene I, Kaklauskiene L. A Review of AI Cloud and Edge Sensors, Methods, and Applications for the Recognition of Emotional, Affective and Physiological States. SENSORS (BASEL, SWITZERLAND) 2022; 22:7824. [PMID: 36298176 PMCID: PMC9611164 DOI: 10.3390/s22207824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/28/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Affective, emotional, and physiological states (AFFECT) detection and recognition by capturing human signals is a fast-growing area, which has been applied across numerous domains. The research aim is to review publications on how techniques that use brain and biometric sensors can be used for AFFECT recognition, consolidate the findings, provide a rationale for the current methods, compare the effectiveness of existing methods, and quantify how likely they are to address the issues/challenges in the field. In efforts to achieve the key goals of Society 5.0, Industry 5.0, and human-centered design better, the recognition of emotional, affective, and physiological states is progressively becoming an important matter and offers tremendous growth of knowledge and progress in these and other related fields. In this research, a review of AFFECT recognition brain and biometric sensors, methods, and applications was performed, based on Plutchik's wheel of emotions. Due to the immense variety of existing sensors and sensing systems, this study aimed to provide an analysis of the available sensors that can be used to define human AFFECT, and to classify them based on the type of sensing area and their efficiency in real implementations. Based on statistical and multiple criteria analysis across 169 nations, our outcomes introduce a connection between a nation's success, its number of Web of Science articles published, and its frequency of citation on AFFECT recognition. The principal conclusions present how this research contributes to the big picture in the field under analysis and explore forthcoming study trends.
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Affiliation(s)
- Arturas Kaklauskas
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Ajith Abraham
- Machine Intelligence Research Labs, Scientific Network for Innovation and Research Excellence, Auburn, WA 98071, USA
| | - Ieva Ubarte
- Institute of Sustainable Construction, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Romualdas Kliukas
- Department of Applied Mechanics, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Vaida Luksaite
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Arune Binkyte-Veliene
- Institute of Sustainable Construction, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Ingrida Vetloviene
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
| | - Loreta Kaklauskiene
- Department of Construction Management and Real Estate, Vilnius Gediminas Technical University, Sauletekio Ave. 11, LT-10223 Vilnius, Lithuania
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Dulin AJ, Park JW, Scarpaci MM, Dionne LA, Sims M, Needham BL, Fava JL, Eaton CB, Kanaya AM, Kandula NR, Loucks EB, Howe CJ. Examining relationships between perceived neighborhood social cohesion and ideal cardiovascular health and whether psychosocial stressors modify observed relationships among JHS, MESA, and MASALA participants. BMC Public Health 2022; 22:1890. [PMID: 36221065 PMCID: PMC9552445 DOI: 10.1186/s12889-022-14270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Psychosocial stressors increase the risks for cardiovascular disease across diverse populations. However, neighborhood level resilience resources may protect against poor cardiovascular health (CVH). This study used data from three CVH cohorts to examine longitudinally the associations of a resilience resource, perceived neighborhood social cohesion (hereafter referred to as neighborhood social cohesion), with the American Heart Association's Life's Simple 7 (LS7), and whether psychosocial stressors modify observed relationships. METHODS We examined neighborhood social cohesion (measured in tertiles) and LS7 in the Jackson Heart Study, Multi-Ethnic Study of Atherosclerosis, and Mediators of Atherosclerosis in South Asians Living in America study. We used repeated-measures, modified Poisson regression models to estimate the relationship between neighborhood social cohesion and LS7 (primary analysis, n = 6,086) and four biological metrics (body mass index, blood pressure, cholesterol, blood glucose; secondary analysis, n = 7,291). We assessed effect measure modification by each psychosocial stressor (e.g., low educational attainment, discrimination). RESULTS In primary analyses, adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) for ideal/intermediate versus poor CVH among high or medium (versus low) neighborhood social cohesion were 1.01 (0.97-1.05) and 1.02 (0.98-1.06), respectively. The psychosocial stressors, low education and discrimination, functioned as effect modifiers. Secondary analyses showed similar findings. Also, in the secondary analyses, there was evidence for effect modification by income. CONCLUSION We did not find much support for an association between neighborhood social cohesion and LS7, but did find evidence of effect modification. Some of the effect modification results operated in unexpected directions. Future studies should examine neighborhood social cohesion more comprehensively and assess for effect modification by psychosocial stressors.
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Affiliation(s)
- Akilah J Dulin
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA.
- Center for Health Promotion and Health Equity Research, Brown University School of Public Health, Box G-S121-8, 02912, Providence, RI, USA.
| | - Jee Won Park
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Matthew M Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA
| | - Laura A Dionne
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
| | - Mario Sims
- Department of Social Medicine, Population and Public Health, University of California Riverside School of Medicine, Riverside, CA, USA
| | - Belinda L Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Joseph L Fava
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Charles B Eaton
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for Primary Care and Prevention Kent Memorial Hospital, Warwick, RI, USA
| | - Alka M Kanaya
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Namratha R Kandula
- Department of Internal Medicine, Northwestern University, Chicago, IL, USA
| | - Eric B Loucks
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Chanelle J Howe
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
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Rahal D, Shaw S. Impacts of the COVID-19 Transition to Remote Instruction for University Students. JOURNAL OF STUDENT AFFAIRS RESEARCH AND PRACTICE 2022; 60:108-122. [PMID: 36818329 PMCID: PMC9937512 DOI: 10.1080/19496591.2022.2111519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
In March 2020, 234 students (77.50% female; 63.09% second-year, 28.33% third-year) enrolled in a psychological statistics course at a public university described their experiences during the first week of the COVID-19-related transition to remote instruction. Qualitative responses indicated 13 common concerns including financial, housing, and food insecurity; social life concerns; distress; sleep difficulties; and academic problems. Students with lower socioeconomic status were more likely to experience financial instability, food insecurity, and difficulty focusing academically.
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Cao D, Zhou Z, Ren Y, Deng Q, Zhai X, Liu G, Zhao D, Zhao Y, Shen C. The relationship between duration of subjective poverty and health among Chinese adults: Evidence from the China Family Panel Study. Front Public Health 2022; 10:939569. [PMID: 36276380 PMCID: PMC9581302 DOI: 10.3389/fpubh.2022.939569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/02/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction The disadvantaged socioeconomic status could have accumulated negative effects on individual. In the Chinese context, studying subjective and relative poverty is more important under the implementation of the Targeted Poverty Alleviation campaign. This study aims to provide evidence of the relationship between the duration of subjective poverty and both physical and mental health among Chinese adults, using nationally longitudinal data from 2010 to 2018. Materials and methods Data were extracted from a nationally representative survey database-the China Family Panel Study (CFPS). The total sample size contains 12,003 adults, with 3,532 in the urban area and 8,471 in the rural area. Self-rated health and depressive symptoms were set as indicators of physical health and mental health, respectively. The duration of subjective poverty was measured by self-rated income level in the local area from 2010 to 2016. A series of ordinary least square regression was adopted to measure the relationship between duration of subjective poverty and health. Results For the urban residents, the average duration of subjective poverty is 1.99 time points, while 1.98 time points for the rural residents. Net of objective poverty, duration of subjective poverty has a significantly negative association with individual's self-rated health in the rural sample (Coef. = -0.10, p < 0.001). Compared with those who have not experienced subjective poverty, the self-rated health score of people who experienced four time points is likely to decrease by 0.54 in the rural area and 0.30 in the urban area. In terms of mental health, 1 unit increase in the duration of subjective poverty is related to 0.15 unit increase in Center for Epidemiologic Studies Depression Scale-8 (CES-D8) scores in the urban sample and 0.46 in the rural sample. Compared with those who have not experienced subjective poverty, the CES-D8 scores of people who experienced four time points are likely to increase by 1.47 in the rural area and 0.95 in the urban area. Conclusion A longer duration of subjective poverty has a cumulatively negative effect on Chinese residents' physical and mental health, especially in rural area. Our study advocates researchers and policymakers pay more attention to the cumulative effect of subjective poverty on health.
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Affiliation(s)
- Dan Cao
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China,*Correspondence: Zhongliang Zhou
| | - Yangling Ren
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China
| | - Qiwei Deng
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Xiaohui Zhai
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Guanping Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Dantong Zhao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Yaxin Zhao
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Chi Shen
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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Lockwood KG, Peddie L, Crosswell AD, Hives BA, Slopen N, Almeida DM, Puterman E. Effects of Chronic Burden Across Multiple Domains and Experiences of Daily Stressors on Negative Affect. Ann Behav Med 2022; 56:1056-1067. [PMID: 35195708 PMCID: PMC9528775 DOI: 10.1093/abm/kaac001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Exposure to chronic psychological stress across multiple life domains (multi-domain chronic burden) is associated with poor health. This may be because multi-domain chronic burden influences daily-level emotional processes, though this hypothesis has not been thoroughly tested. PURPOSE The current study tested whether (a) multi-domain chronic burden is associated with greater exposure to daily stressors and (b) multi-domain chronic burden compounds negative affect on days with stressors compared to stressor-free days. METHODS The MIDUS Study (Wave II) and the National Study of Daily Experiences sub-study were conducted from 2004 to 2006 (N = 2,022). Participants reported on eight life domains of psychological stress used to create a multi-domain chronic burden summary score. For eight consecutive days, participants reported the daily occurrence of stressful events and daily negative affect. RESULTS Participants with greater multi-domain chronic burden were significantly more likely to report daily stressors. There was also a significant interaction between multi-domain chronic burden and daily stressors on negative affect: participants with higher multi-domain chronic burden had greater negative affect on stressor days than stressor-free days compared to those with lower multi-domain chronic burden. CONCLUSION Participants with higher multi-domain chronic burden were more likely to report daily stressors and there was a compounding effect of multi-domain chronic burden and daily stressors on negative affect. These results suggest that experiencing a greater amount of psychological stress across multiple life domains may make daily stressors more toxic for daily affect.
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Affiliation(s)
- Kimberly G Lockwood
- Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Luke Peddie
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T1Z1, Canada
| | - Alexandra D Crosswell
- Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - Benjamin A Hives
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T1Z1, Canada
| | - Natalie Slopen
- Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - David M Almeida
- Human Development and Family Studies, Penn State University, University Park, PA,USA
| | - Eli Puterman
- School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T1Z1, Canada
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Schelleman-Offermans K, Ruiter RAC, Massar K. The Future Positive micro-intervention protocol: A program aiming to increase a healthy life-style among employees with a low socio-economic position. Front Public Health 2022; 10:832447. [PMID: 36211694 PMCID: PMC9540196 DOI: 10.3389/fpubh.2022.832447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 08/26/2022] [Indexed: 01/21/2023] Open
Abstract
This paper describes the development of a Dutch micro-intervention, Future Positive, that aims to increase health behaviors among employees with a low socio-economic position (SEP), with the ultimate aim to decrease socio-economic health inequalities. Intervention Mapping (IM) was used to adapt previously developed psychological capital interventions into a micro-intervention suitable to be delivered in the work context for employees with a low socio-economic position. The first 4 steps of IM including the results of pre-testing the developed intervention program are described. Step 1 consists of the needs assessment, and investigated (a) the individual determinants of health behavior and health inequalities, and (b) the needs of employees with a low SEP and their employers regarding the implementation of the intervention at the worksite. Matrices-of-change were produced in Step 2, and relevant methods and applications were selected in step 3. Step 4 involved the intervention development, resulting in a brief micro-intervention that will be delivered in small groups, guided by trained facilitators using motivational interviewing techniques. Program materials include informative video-clips and active and cooperative learning exercises. The intervention was pre-tested among three groups of employees. The IM process, as well as the pre-testing, revealed that emphasizing autonomy and using easy to understand and mostly visual materials offered in chunks is essential for a well-tailored intervention that is suitable for people with low SEP. Also, participation should be facilitated by employers: It should be free of costs, offered during working hours, and take place at the job site. Results showed that the Future Positive micro-intervention is substantiated by theory, applicable in a work setting (high reach), and tailored to the needs of employees with a low SEP. We therefore fill the gap in this existing range of interventions aimed to improve life-style behaviors and contribute to theory-based interventions aimed to decrease the SEP-Health gradient.
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Zhu G, Jiang S, Li K. A moderated mediation mechanism underlying the impact of website telepresence on purchase intention - Evidence from Chinese female college student customers. Front Psychol 2022; 13:902414. [PMID: 36118452 PMCID: PMC9478893 DOI: 10.3389/fpsyg.2022.902414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022] Open
Abstract
Telepresence in e-commerce, the feeling of resembling shopping in a physical store, plays a critical role in determining online purchase intention. However, the cognitive mechanism and boundary conditions about its effect still need further investigation. The current study construed flow experience and socioeconomic status as important variables and developed a moderated mediation model for their roles in the effect of telepresence. The model was supported by our study where a group of Chinese female college students participated in simulated online apparel shopping and completes relevant questionnaire surveys. The results show that: (1) website telepresence predicts positively the purchase intention of females, (2) flow experience mediates the impact of website telepresence on purchase intention, and (3) the relationship between website telepresence and flow experience could be moderated by socioeconomic status, namely, females with higher socioeconomic status demonstrate stronger mediation of flow experience. These findings can help researchers and online retailers understand the flow concept in e-commerce and formulate marketing strategies to retain consumers with different socioeconomic statuses.
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Affiliation(s)
- Guiqin Zhu
- School of Education, Chongqing Normal University, Chongqing, China
| | - Shuaihe Jiang
- School of Law and Sociology, Xinyang Normal University, Xinyang, China
| | - Kai Li
- School of Management, Xi’an University of Architecture and Technology, Xi’an, China
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Impacts of Self-Efficacy on Food and Dietary Choices during the First COVID-19 Lockdown in China. Foods 2022; 11:foods11172668. [PMID: 36076852 PMCID: PMC9455677 DOI: 10.3390/foods11172668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has caused a global public health emergency, increasing the prevalence of emotional distress, and potentially leading to altered diet behavior. Self-efficacy measures various aspects of perceiving and understanding emotions. The present study was carried out with the objective of understanding the effect of emotional self-efficacy on dietary behavior and quality. It also shed light on which elements contributed to the link between food-related behavior and perceived dietary quality during the first lockdown of the COVID-19 pandemic. Based on the factor analysis of nineteen food groups, choices, consumption, and socioeconomic status were examined in a sample of 441 Chinese participants. Multiple linear regression examined the association between food consumption, dietary quality, and self-efficacy. Contrary to prior research, the intake of salty snacks and alcoholic beverages dropped by 3.3% and 2.8%, respectively, during the first lockdown. Emotional self-efficacy negatively mediated the relationship between socioeconomic status and dietary quality. In conclusion, emotional self-efficacy is a well-established tool for evaluating how Chinese people cope with negative emotions. As an individual’s dietary quality was affected during the imposed lockdown, the present study offers valuable insight into psychosocial factors that may contribute to health disparities by advocating for organized nutritional support in future epidemic-related quarantines.
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Knight EL. Two Routes to Status, One Route to Health: Trait Dominance and Prestige Differentially Associate with Self-reported Stress and Health in Two US University Populations. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2022; 8:461-488. [PMID: 36034092 PMCID: PMC9395955 DOI: 10.1007/s40750-022-00199-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/25/2022] [Accepted: 08/01/2022] [Indexed: 12/03/2022]
Abstract
Objective Social status has been extensively linked to stress and health outcomes. However, two routes by which status can be earned – dominance and prestige – may not uniformly relate to lower stress and better health because of inherent behavioral and stress-exposure differences in these two routes. Methods In one exploratory and two preregistered studies, participants (total N = 978) self-reported their trait dominance and prestige and self-reported several stress and health outcomes. Results The meta-effects evident across the three studies indicate that higher trait dominance was associated with worse outcomes – higher stress, poorer physical and mental health, poorer behavioral health, poorer life satisfaction, higher negative affect (range of absolute values of non-zero correlations, |r| = [0.074, 0.315], ps < 0.021) – and higher trait prestige was associated with better outcomes – lower stress, better physical and mental health, better behavioral health, better life satisfaction, higher positive and lower negative mood (|r| = [0.134, 0.478], ps < 0.001). These effects remained evident (with few exceptions) after controlling for socioeconomic status, other status-relevant traits, or self-enhancing motives; associations with behavior relevant to the COVID19 pandemic generally were not robust. Conclusions This work indicates that evolved traits related to the preferred route by which status is earned likely impact self-reported stress and health outcomes. Future research is necessary to examine physiological and other objective indicators of stress and health in more diverse populations. Supplementary Information The online version contains supplementary material available at 10.1007/s40750-022-00199-3.
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Fujimoto Y, Ferdous A, Wali F. Integrative Resource Model of Workplace Inclusion for Reduced Inequality: Conservation of Resources Perspective. JOURNAL OF BUSINESS ETHICS : JBE 2022; 187:1-23. [PMID: 35999829 PMCID: PMC9389506 DOI: 10.1007/s10551-022-05218-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
This study provides much-needed empirical study of workplace inclusion of underresourced employees of low socioeconomic status. Based upon a conservation of resources perspective, we have examined the centrality of resources as a key inclusion process for well-being outcomes for employees with insufficient resources. In the context of misuse of institutional power over operative workers within highly segmented and hierarchical work settings, this study validates the importance of economic inclusion for fostering workers' well-being via fair employment practices. This study also offers new knowledge of the integrative resource model of workplace inclusion research by validating workers' personal resources of learning orientation as an internal condition for strengthening the positive effect of economic inclusion on well-being.
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Affiliation(s)
- Yuka Fujimoto
- Department of Management, Sunway University, Petaling Jaya, Malaysia
| | - Ahmed Ferdous
- Department of Marketing, Deakin University, Geelong, Australia
| | - Faisal Wali
- Department of Management, North South University, Dhaka, Bangladesh
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Predictors of emotional distress in uveal melanoma survivors: a systematic review. Eye (Lond) 2022; 37:907-924. [PMID: 35941183 PMCID: PMC10049992 DOI: 10.1038/s41433-022-02193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022] Open
Abstract
Uveal melanoma (UM) survivors can experience significant emotional distress, although the factors underpinning this are poorly understood. Systematic reviews of distress in UM only include cross-sectional studies, thereby limiting our understanding of causal factors. This review identified prospective clinical, demographic, social and psychological predictors of distress in UM survivors. A systematic search of the literature for English language prospective studies was conducted. Thirteen papers, reporting data from seven unique datasets were included in a narrative synthesis of the results. Younger age (3 studies from 3 datasets), physical health (including visual impairment, ocular symptoms, and other UM-related factors; 3 studies from 3 datasets), and psychological factors (mainly baseline distress; 3 studies from 3 datasets and worry about recurrence; 2 studies from 2 datasets), significantly predicted distress. There was no consistent evidence for other demographic, clinical or social variables (significant in <50% of datasets). Generally, the quality of the papers was adequate. However, attrition rates were high or not reported in over half of the included studies. The findings of this review emphasise the importance of attempts to prevent and recognise distress immediately post-diagnosis of UM. Particular focus should be given to younger patients, those with physical and psychological health difficulties at the time of diagnosis, and those who develop adverse treatment symptoms during survivorship. More research into potential social and psychological variables and their role in predicting distress in survivors is recommended.
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Zelaya DG, Guy AA, Surace A, Mastroleo NR, Pantalone DW, Monti PM, Mayer KH, Kahler CW. Modeling the Impact of Race, Socioeconomic Status, Discrimination and Cognitive Appraisal on Mental Health Concerns Among Heavy Drinking HIV+ Cisgender MSM. AIDS Behav 2022; 26:3925-3938. [PMID: 35687187 DOI: 10.1007/s10461-022-03719-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2022] [Indexed: 11/26/2022]
Abstract
Prior research has attributed mental health disparities between marginalized and non-marginalized populations to socioeconomic differences (i.e., education, income, employment), stigma (e.g., HIV-related discrimination), and cognitive appraisal (i.e., optimism, hostility, satisfaction with life), but the relations among these variables have not been examined concomitantly. The current study utilized structural equation modeling to examine how race and socioeconomic status impact mental health outcomes through increased exposure to stigma and more negative cognitive appraisals. Data came from a randomized controlled trial of motivational interviewing to address heavy drinking in cisgender men with HIV who have sex with men (n = 180). We found that self-reported discrimination experiences related to race/ethnicity, sexual orientation, and HIV status significantly mediated the relation between socioeconomic status and mental health concerns, whereas cognitive appraisal did not. These findings suggest that, among heavy drinking men with HIV who have sex with men, having low socioeconomic resources may increase exposure to discrimination which, in turn, may worsen mental health. Interventions that address social determinants, like socioeconomic disadvantage, and that enhance coping resources related to stigma, may have positive effects on mental health.ClinicalTrials.gov Identifier NCT01328743. Date of Registration 09/09/2019.
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Affiliation(s)
- David G Zelaya
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Arryn A Guy
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI, USA
| | - Anthony Surace
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA
| | | | - David W Pantalone
- Fenway Health Boston, Boston, MA, USA
- University of Massachusetts, Boston, MA, USA
| | - Peter M Monti
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA
| | - Kenneth H Mayer
- Fenway Health Boston, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christopher W Kahler
- Alcohol Research Center on HIV, Center for Alcohol and Addiction Studies, Brown University School of Public Health, Box G-S121-4, Providence, RI, 02912, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School at Brown University, Providence, RI, USA
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Liu D, Shen S, Shillair R, Li F, Chen Z. How does home ownership affect migrants' sense of relative deprivation? An investigation based on field theory. Soc Sci Med 2022; 306:115097. [PMID: 35704981 DOI: 10.1016/j.socscimed.2022.115097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 03/22/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND China is continuing to witness rising numbers of migrants (e.g., individuals migrating from rural to urban areas), and alongside this are the social restrictions and institutional barriers migrants face. Such restrictions and barriers are a consequence of the long-standing urban-rural dualist system and can create a sense of relative deprivation among migrants-that is, dissatisfaction when migrants perceive they are at a disadvantage compared with local residents of an area. OBJECTIVE AND METHOD Based on Pierre Bourdieu's field theory, the current study used data from the 2017 Chinese General Social Survey (N = 1849) to explore the mechanism through which migrants' home ownership or non-ownership in the migration process affects their sense of relative deprivation. To do so, a ranked regression and parallel multiple mediation model were developed. Additionally, a heterogeneity analysis was conducted to account for the region in which migrants lived and their age. RESULTS The results revealed that home ownership significantly reduced migrants' relative deprivation. Moreover, the perception of economic and symbolic capital was found to play a role in the effects of wealth and class, respectively. From the heterogeneity analysis, the direct and mediated effects of housing attributes on migrants' relative deprivation were more significant for migrants in the eastern versus central and western regions of China, as well as among new-versus older-generation migrants. CONCLUSION To improve the feasibility of home ownership among migrants and, thus, alleviate their relative deprivation in the inflow area, relevant policies (e.g., improving the housing system pathway) should be developed and implemented.
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Affiliation(s)
- Danchen Liu
- College of Public Administration, Nanjing Agricultural University, Nanjing, China.
| | - Suyan Shen
- College of Public Administration, Nanjing Agricultural University, Nanjing, China.
| | - Ruth Shillair
- Media & Information Studies, College of Communication Arts and Sciences, Michigan State University, MI, USA.
| | - Fang Li
- College of Public Administration, Nanjing Agricultural University, Nanjing, China.
| | - Zhe Chen
- College of Public Administration, Nanjing Agricultural University, Nanjing, China.
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74
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Jeong SS, Gong Y, Henderson A. Sympathy or distress? The moderating role of negative emotion differentiation in helping behavior. ASIA PACIFIC JOURNAL OF MANAGEMENT 2022. [DOI: 10.1007/s10490-022-09819-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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75
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Sugisawa H, Harada K, Sugihara Y, Yanagisawa S, Shinmei M. Mediators of Life-Course and Late-Life Financial Strain on Late-Life Health in Japan: Based on a Cross-Sectional Survey. J Multidiscip Healthc 2022; 15:883-896. [PMID: 35502154 PMCID: PMC9056103 DOI: 10.2147/jmdh.s356760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/22/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hidehiro Sugisawa
- International Graduate School for Advanced Studies, J. F. Oberlin University, Machida-shi, Tokyo, Japan
- Correspondence: Hidehiro Sugisawa, International Graduate School for Advanced Studies, J. F. Oberlin University, 3758, Machida-shi, Tokyo, 194-0294, Japan, Tel/Fax +81(0)02-797-9847, Email
| | - Ken Harada
- Department of Humanities and Social Sciences, Jissen Women’s University, Shibuya-ku, Japan
| | - Yoko Sugihara
- Department of Urban Science and Policy, Tokyo Metropolitan University, Hachioji-shi, Japan
| | - Shizuko Yanagisawa
- Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University, Tokushima-shi, Japan
| | - Masaya Shinmei
- Faculty of Human Welfare, Den-En Chofu University, Kawasaki Shi, Japan
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76
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Harvey MW, Slatcher RB, Husain SA, Imami L, Zilioli S. Socioeconomic status and medication adherence among youth with asthma: the mediating role of frequency of children's daily routines. Psychol Health 2022; 37:507-522. [PMID: 33393826 PMCID: PMC8787831 DOI: 10.1080/08870446.2020.1869739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/22/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The current research aims to examine a potential explanation for SES disparities in youth medication adherence: the frequency of children's daily routines. DESIGN In a cross-sectional sample of 194 youth with asthma (112 boys and 82 girls; average age = 12.8 years old) and their primary caregivers primarily from the Detroit metropolitan area, caregivers reported their SES and the frequency of their children's daily routines during the first laboratory visit. At a follow-up visit, caregivers and their children completed the Family Asthma Management System Scale (FAMSS), a well-validated, semi-structured interview that assess children's degree of adherence to prescribed medications. MAIN OUTCOME MEASURES Children's daily routines were measured with the Child Routines Inventory while children's medication adherence was measured with the FAMSS. RESULTS Mediation analyses revealed that the association between subjective (but not objective) SES and medication adherence was partially mediated by the frequency of children's daily routines. CONCLUSION These results suggest that the frequency of children's daily routines is an important factor linking SES and medication adherence, a finding with important implications for improving health outcomes and reducing health disparities between low SES children and their high SES counterparts.
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Affiliation(s)
| | | | - S. Akbar Husain
- College of Medicine, Central Michigan University, Mount Pleasant
| | - Ledina Imami
- Department of Psychology, Wayne State University, Detroit
| | - Samuele Zilioli
- Department of Psychology, Wayne State University, Detroit
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit
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77
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Yan W, Zhang L, Li W, You X, Kong F. Associations of family subjective socioeconomic status with hedonic and eudaimonic well-being in emerging adulthood: A daily diary study. Soc Sci Med 2022; 298:114867. [PMID: 35276625 DOI: 10.1016/j.socscimed.2022.114867] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 02/20/2022] [Accepted: 02/24/2022] [Indexed: 02/05/2023]
Abstract
Empirical evidence based on retrospective measures has shown that family subjective socioeconomic status (FSSS) was connected to well-being, but few studies have examined this relationship using a daily diary design. Here, we examined the link between FSSS and well-being as well as the mediating roles of social support and self-esteem in a total of 220 emerging adults using a 14-day daily diary design. The multilevel regression analysis found that FSSS positively predicted two types of well-being, including hedonic well-being (HWB) and eudaimonic well-being (EWB). Moreover, the multilevel 2-2-1 mediation analysis indicated that social support and self-esteem performed as independent mediators of the associations between FSSS and two types of well-being. The mediating effect of self-esteem also had no significant difference from that of social support. Furthermore, when age, gender, and family objective socioeconomic status were controlled, these findings remained significant. The implications and limitations of the findings are also discussed.
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Affiliation(s)
- Wenjing Yan
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Linting Zhang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Wenjie Li
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Xuqun You
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Feng Kong
- School of Psychology, Shaanxi Normal University, Xi'an, China.
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78
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Socioeconomic position and pain: a topical review. Pain 2022; 163:1855-1861. [PMID: 35297800 DOI: 10.1097/j.pain.0000000000002634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 02/02/2022] [Indexed: 11/26/2022]
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79
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Claro PJA, Koivusilta L, Vainikainen MP, Rimpelä A. Psychosocial reserve capacity, family background and selection of an educational path – a longitudinal study from Finland. INTERNATIONAL JOURNAL OF ADOLESCENCE AND YOUTH 2022. [DOI: 10.1080/02673843.2022.2043916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Paulyn Jean Acacio Claro
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Ateneo Graduate School of Business, Ateneo de Manila University, Makati City, Philippines
| | - Leena Koivusilta
- Faculty of Social Sciences, Department of Social Research, University of Turku, Turku, Finland
| | | | - Arja Rimpelä
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- Perla – Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland
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80
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Age and socioeconomic differences in coping with home stressors: A daily diary study of mindfulness and anticipatory coping. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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81
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Choi HS, Lee JE. Factors Affecting Depression in Middle-Aged and Elderly Men Living Alone: A Cross-Sectional Path Analysis Model. Am J Mens Health 2022; 16:15579883221078134. [PMID: 35184578 PMCID: PMC8864270 DOI: 10.1177/15579883221078134] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The main objectives of this cross-sectional study were to determine the
relationship between socioeconomic status (SES) and depression and to
estimate the mediating effects of social network satisfaction,
self-esteem, and perceived health status among middle-aged and elderly
men living alone, based on the reserve capacity model. Secondary data
from a sample of 394 middle-aged and elderly men aged 45 years or
older from the 15th Korea Welfare Panel Study (KOWEPS) were analyzed.
A path analysis model was constructed to evaluate the relationship
among SES, social network satisfaction, self-esteem, perceived health
status, and depression. The path analysis exhibited significant direct
effects of social network satisfaction, self-esteem, and perceived
health status on depression and significant indirect effects of SES on
depression. There was no direct effect of SES on depression. Social
network satisfaction and self-esteem had significant mediating effects
of SES on depression. Among middle-aged and elderly men, intrapersonal
reserves, which are psychosocial factors including social network
satisfaction, self-esteem, and perceived health status, showed more
association with depression than tangible reserves such as SES. This
suggests that interventions promoting self-esteem and perceived health
status could prevent depression.
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Affiliation(s)
- Hye-Seung Choi
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Eun Lee
- College of Nursing, The Catholic University of Korea, Seoul, Republic of Korea
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82
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Abstract
Health disparities by socioeconomic status (SES) have been extensively documented, but less is known about the physical health implications of achieving upward mobility. This article critically reviews the evolving literature in this area, concluding that upward mobility is associated with a trade-off, whereby economic success and positive mental health in adulthood can come at the expense of physical health, a pattern termed skin-deep resilience. We consider explanations for this phenomenon, including prolonged high striving, competing demands between the environments upwardly mobile individuals seek to enter and their environments of origin, cultural mismatches between adaptive strategies from their childhood environments and those that are valued in higher-SES environments, and the sense of alienation, lack of belonging, and discrimination that upwardly mobile individuals face as they move into spaces set up by and for high-SES groups. These stressors are hypothesized to lead to unhealthy behaviors and a dysregulation of biological systems, with implications for cardiometabolic health.
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Affiliation(s)
- Edith Chen
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA;
| | - Gene H Brody
- Center for Family Research, University of Georgia, Athens, Georgia 30602, USA
| | - Gregory E Miller
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA;
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83
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Imami L, Jiang Y, Murdock KW, Zilioli S. Links Between Socioeconomic Status, Daily Depressive Affect, Diurnal Cortisol Patterns, and All-Cause Mortality. Psychosom Med 2022; 84:29-39. [PMID: 34419996 DOI: 10.1097/psy.0000000000001004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Socioeconomic status (SES) remains a robust risk factor for mortality. Various theoretical models postulate that lower SES is associated with higher negative affect, which then initiates a cascade of physiological disturbances that contribute to illness and early mortality. However, few studies have explicitly investigated the interplay between psychological and biological factors in determining SES disparities in mortality. This study examined the role of daily negative affect and cortisol secretion in explaining the SES-mortality link in a large sample of US adults. METHODS Using data from the Midlife in the United States study (n = 1735, mean [standard deviation] age = 56.40 [12.10] years, 56.4% female), we tested longitudinal associations between SES, daily negative affect, daily cortisol levels, and all-cause mortality 13 years later. Daily negative affect was classified into three clusters reflecting depressive affect, anxiety, and anger. RESULTS Higher SES was linked to a lower risk of all-cause mortality (hazard ratio = 0.94, 95% confidence interval = 0.90 to 0.97). Furthermore, there was a sequential link between higher SES and lower mortality through lower daily depressive affect and a steeper ("healthier") diurnal cortisol slope (indirect effect = -0.0007, 95% confidence interval = -0.0014 to -0.0002). Daily anxiety and anger were not associated with cortisol levels or mortality (p values > .05). CONCLUSIONS These findings suggest that daily negative emotional experiences and the hypothalamic-pituitary-adrenal axis functioning may constitute important psychological and physiological pathways underlying the link between SES and all-cause mortality.
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Affiliation(s)
- Ledina Imami
- From the Department of Psychology (Imami), Purdue University, West Lafayette, Indiana; Department of Psychology (Jiang, Zilioli), Wayne State University, Detroit, Michigan; Department of Biobehavioral Health (Murdock), The Pennsylvania State University, University Park, Pennsylvania; and Department of Family Medicine and Public Health Sciences (Zilioli), Wayne State University, Detroit, Michigan
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84
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Abstract
OBJECTIVES Financial debt held by older adults in the U.S. has grown over the past two decades. This study examines the extent to which credit cards, other consumer debts, and mortgage debt increase financial stress. Outcome measures of financial stress include the material domain ("bill-paying difficulty") and psychological domain ("ongoing financial strain"). METHOD We analyzed adults age 62 and older in the 2004 to 2016 waves of the Health and Retirement Study using random-effects logit regressions. RESULTS Unsecured consumer debt is associated with more financial stress per dollar than mortgage debt. A detailed assessment of mortgage debt finds that greater levels of both first and secondary mortgages are associated with greater bill-paying difficulty and greater ongoing financial strain. An increase in new mortgage debt obtained after age 62 is associated with an increase in bill-paying difficulty, but is not significantly associated with ongoing financial strain. In contrast, a reduction in mortgage debt since age 62 is associated with lower bill-paying difficulty and lower levels of ongoing financial strain. CONCLUSION The relationship between consumer debt, mortgages, and financial stress is nuanced, and depends on both the type and timing of the debt.
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Affiliation(s)
- Cäzilia Loibl
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Stephanie Moulton
- John Glenn College of Public Affairs, The Ohio State University, Columbus, OH, USA
| | - Donald Haurin
- Department of Economics, The Ohio State University, Columbus, OH, USA
| | - Chrisse Edmunds
- Department of Sociology, The Ohio State University, Columbus, OH, USA
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85
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Hyun J, Hall CB, Katz MJ, Derby CA, Lipnicki DM, Crawford JD, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Bae JB, Röhr S, Riedel-Heller S, Ganguli M, Jacobsen E, Hughes TF, Brodaty H, Kochan NA, Trollor J, Lobo A, Santabarbara J, Lopez-Anton R, Sachdev PS, Lipton RB. Education, Occupational Complexity, and Incident Dementia: A COSMIC Collaborative Cohort Study. J Alzheimers Dis 2022; 85:179-196. [PMID: 34776437 PMCID: PMC8748312 DOI: 10.3233/jad-210627] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Education and occupational complexity are main sources of mental engagement during early life and adulthood respectively, but research findings are not conclusive regarding protective effects of these factors against late-life dementia. OBJECTIVE This project aimed to examine the unique contributions of education and occupational complexity to incident dementia, and to assess the mediating effects of occupational complexity on the association between education and dementia across diverse cohorts. METHOD We used data from 10,195 participants (median baseline age = 74.1, range = 58∼103), representing 9 international datasets from 6 countries over 4 continents. Using a coordinated analysis approach, the accelerated failure time model was applied to each dataset, followed by meta-analysis. In addition, causal mediation analyses were performed. RESULT The meta-analytic results indicated that both education and occupational complexity were independently associated with increased dementia-free survival time, with 28%of the effect of education mediated by occupational complexity. There was evidence of threshold effects for education, with increased dementia-free survival time associated with 'high school completion' or 'above high school' compared to 'middle school completion or below'. CONCLUSION Using datasets from a wide range of geographical regions, we found that both early life education and adulthood occupational complexity were independently predictive of dementia. Education and occupational experiences occur during early life and adulthood respectively, and dementia prevention efforts could thus be made at different stages of the life course.
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Affiliation(s)
- Jinshil Hyun
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles B. Hall
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A. Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - John D. Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jong Bin Bae
- Department of Brain & Cognitive Sciences, Seoul National University, Seoul, South Korea
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | | | | | | | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabarbara
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Raul Lopez-Anton
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard B. Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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86
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Thomas MD, Mendez RM, Zhang Y, Wang Y, Sohail S, Chae DH, Márquez-Magaña L, Sellers R, Woods-Giscombé CL, Allen AM. OUP accepted manuscript. THE GERONTOLOGIST 2022; 62:762-772. [PMID: 35084030 PMCID: PMC9154235 DOI: 10.1093/geront/gnac005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives African American women experience faster telomere shortening (i.e., cellular aging) compared with other racial–gender groups. Prior research demonstrates that race and gender interact to influence culturally specific norms for responding to socially-relevant stress and other stress-coping processes, which may affect healthy aging. Research Design and Methods Data are from African American Women’s Heart & Health Study participants who consented to DNA extraction (n = 140). Superwoman Schema (SWS) was measured using 5 validated subscales: presenting strength, emotion suppression, resisting vulnerability, motivation to succeed, and obligation to help others. Racial identity was measured using 3 subscales from the Multidimensional Inventory of Black Identity: racial centrality, private regard, and public regard. Relative telomere length (rTL) was measured using DNA extracted from blood samples. Path analysis tested associations and interactions between SWS and racial identity dimensions with rTL. Results For SWS, higher resistance to being vulnerable predicted longer telomeres. For racial identity, high private regard predicted longer telomeres while high public regard predicted shorter telomeres. Interactions were found between public regard and 2 SWS dimensions: among women with high public regard, emotion suppression (β = 0.20, p < .05) and motivation to succeed (β = 0.18, p < .05) were associated with longer rTL. The interaction between high centrality and emotion suppression predicted shorter rTL (β = −0.17, p < .05). Discussion and Implications Culturally specific responses to gendered racism and racial identity, developed early in life and shaped over the life course, are important psychosocial determinants of cellular aging among African American women.
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Affiliation(s)
- Marilyn D Thomas
- Departments of Epidemiology & Biostatistics and Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA
- Address correspondence to: Marilyn D. Thomas, PhD, MPH, Departments of Epidemiology & Biostatistics and Psychiatry & Behavioral Sciences, University of California, San Francisco, 1001 Potrero Avenue, Box 0852, San Francisco, CA 94110, USA. E-mail:
| | - Rebecca M Mendez
- Department of Biology, San Francisco State University, San Francisco, California, USA
| | - Youchuan Zhang
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Yijie Wang
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
| | - Saba Sohail
- Department of Biology, San Francisco State University, San Francisco, California, USA
| | - David H Chae
- Department of Global Community Health and Behavioral Sciences, Tulane University, School of Public Health & Tropical Medicine, New Orleans, Louisiana, USA
| | | | - Rob Sellers
- Office of Diversity, Equity & Inclusion, University of Michigan, Ann Arbor, Michigan, USA
| | - Cheryl L Woods-Giscombé
- School of Nursing, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, USA
| | - Amani M Allen
- School of Public Health, Divisions of Community Health Sciences and Epidemiology, University of California, Berkeley, Berkeley, California, USA
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87
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Pan Y, Aierken A, Ding X, Chen Y, Li Y. Socioeconomic Status Association With Dependency From Objective and Subjective Assessments: A Cross-Sectional Study. Front Psychiatry 2022; 13:898686. [PMID: 35845452 PMCID: PMC9276981 DOI: 10.3389/fpsyt.2022.898686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/31/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The effect of socioeconomic status (SES) on dependency is still complex and not fully clear. The purposes of this study are to assess the association between SES and dependency personality disorder (DPD) using both objective and subjective assessments. METHODS A cross-sectional study was conducted in 27 locations in China among 1,276 general residents aged 60 years and above through a complex multistage sampling design. Data were collected using a questionnaire by well-trained investigators through face-to-face interviews. The DPD was assessed using a standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II scale. Objective SES was assessed by the combination of education levels, individual income, preretirement occupation, and medical insurance. Subjective SES was measured using the MacArthur Scale. The logistic regression analysis was used to evaluate the association between objective SES and DPD. Analysis of covariance was conducted to compare the mean of DPD scores in different levels of SES. RESULTS The results of the chi-squared test showed that the levels of objective SES were associated with DPD, depression, social resources, and region. The logistic regression analysis showed a significant negative association between the levels of objective SES and DPD. The odds ratio was 1.84 (95% confidence interval, 1.07-3.18) after adjusting for important confounding factors. The analysis of covariance showed differences in the mean of DPD scores among different groups defined by different levels of SES. CONCLUSION The levels of SES were negatively associated with DPD, and subjective SES had a stronger association with DPD than objective SES. The effect of subjective SES on DPD is possibly associated with the perception of position in the social hierarchy.
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Affiliation(s)
- YiYang Pan
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Ayizuhere Aierken
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - XiWen Ding
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Yuan Chen
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
| | - Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, China
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88
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Wright L, Lopez LS, Camargo G, Bukowski WM. Psychophysiological adjustment to formal education varies as a function of peer status and socioeconomic status in children beginning kindergarten. Dev Psychobiol 2021; 63 Suppl 1:e22225. [PMID: 34964493 DOI: 10.1002/dev.22225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 10/09/2021] [Accepted: 10/26/2021] [Indexed: 11/10/2022]
Abstract
The transition to kindergarten can be stressful as children adjust to novel separations from their caregivers and become accustomed to their peer group. A 9-month study of 96 children (Mage = 5.37 years, SD = 0.42) from Barranquilla, Colombia, assessed socioeconomic differences in hypothalamic-pituitary-adrenal (HPA) axis functioning across the kindergarten year. Children were from four different classrooms in one school. Saliva samples were collected twice a day across 3 consecutive days at the beginning and end of the school year. We examined whether change in HPA axis activation across the year varied as a function of a child's socioeconomic status (SES) and experience in the peer group. We found that rejected children and lower SES children had lower cortisol levels early in the morning. Rejected children had a flatter morning cortisol slope. Lower SES children had higher cortisol than their higher SES peers at the end of the school year and a flatter morning cortisol slope. Taken together, these findings suggest that diurnal cortisol in children beginning kindergarten may be influenced by both peer rejection and SES.
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Affiliation(s)
- Leah Wright
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Luz Stella Lopez
- Instituto de Estudios en Educacion, Universidad del Norte, Barranquilla, Atlantico, Colombia
| | - Gina Camargo
- Instituto de Estudios en Educacion, Universidad del Norte, Barranquilla, Atlantico, Colombia
| | - William M Bukowski
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
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89
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Park JW, Dulin AJ, Needham BL, Sims M, Loucks EB, Fava JL, Dionne LA, Scarpaci MM, Eaton CB, Howe CJ. Examining Optimism, Psychosocial Risks, and Cardiovascular Health Using Life's Simple 7 Metrics in the Multi-Ethnic Study of Atherosclerosis and the Jackson Heart Study. Front Cardiovasc Med 2021; 8:788194. [PMID: 34977194 PMCID: PMC8714850 DOI: 10.3389/fcvm.2021.788194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Optimism has been shown to be positively associated with better cardiovascular health (CVH). However, there is a dearth of prospective studies showing the benefits of optimism on CVH, especially in the presence of adversities, i.e., psychosocial risks. This study examines the prospective relationship between optimism and CVH outcomes based on the Life's Simple 7 (LS7) metrics and whether multilevel psychosocial risks modify the aforementioned relationship. Methods: We examined self-reported optimism and CVH using harmonized data from two U.S. cohorts: Multi-Ethnic Study of Atherosclerosis (MESA) and Jackson Heart Study (JHS). Modified Poisson regression models were used to estimate the relationship between optimism and CVH using LS7 among MESA participants (N = 3,520) and to examine the relationship of interest based on four biological LS7 metrics (body mass index, blood pressure, cholesterol, and blood glucose) among JHS and MESA participants (N = 5,541). For all CVH outcomes, we assessed for effect measure modification by psychosocial risk. Results: Among MESA participants, the adjusted risk ratio (aRR) for ideal or intermediate CVH using LS7 comparing participants who reported high or medium optimism to those with the lowest level of optimism was 1.10 [95% Confidence Interval (CI): 1.04-1.16] and 1.05 (95% CI: 0.99-1.11), respectively. Among MESA and JHS participants, the corresponding aRRs for having all ideal or intermediate (vs. no poor) metrics based on the four biological LS7 metrics were 1.05 (0.98-1.12) and 1.04 (0.97-1.11), respectively. The corresponding aRRs for having lower cardiovascular risk (0-1 poor metrics) based on the four biological LS7 metrics were 1.01 (0.98-1.03) and 1.01 (0.98-1.03), respectively. There was some evidence of effect modification by neighborhood deprivation for the LS7 outcome and by chronic stress for the ideal or intermediate (no poor) metrics outcome based on the four biological LS7 metrics. Conclusion: Our findings suggest that greater optimism is positively associated with better CVH based on certain LS7 outcomes among a racially/ethnically diverse study population. This relationship may be effect measure modified by specific psychosocial risks. Optimism shows further promise as a potential area for intervention on CVH. However, additional prospective and intervention studies are needed.
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Affiliation(s)
- Jee Won Park
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Epidemiology, Brown University, Providence, RI, United States
| | - Akilah J. Dulin
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Eric B. Loucks
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Joseph L. Fava
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
| | - Laura A. Dionne
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Matthew M. Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, United States
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Chanelle J. Howe
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Epidemiology, Brown University, Providence, RI, United States
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90
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Theodoulou A, Lindson N, Fanshawe TR, Thomas J, Nollen N, Ahluwalia JS, Leavens E, Hartmann-Boyce J. The effect of individual-level smoking cessation interventions on socioeconomic inequalities in tobacco smoking. Hippokratia 2021. [DOI: 10.1002/14651858.cd015120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Annika Theodoulou
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - Thomas R Fanshawe
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
| | - James Thomas
- EPPI-Centre, Social Science Research Unit, UCL Institute of Education; University College London; London UK
| | - Nicole Nollen
- Department of Population Health; University of Kansas School of Medicine; Kansas City Kansas USA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences; Brown University School of Public Health and Department of Medicine, Alpert Medical School; Providence Rhode Island USA
| | - Eleanor Leavens
- Department of Population Health; University of Kansas School of Medicine; Kansas City Kansas USA
| | - Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences; University of Oxford; Oxford UK
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91
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Spears EC, Allen AM, Chung KW, Martz CD, Hunter EA, Fuller-Rowell TE, Lim SS, Drenkard C, Chae DH. Anticipatory racism stress, smoking and disease activity: the Black women's experiences living with lupus (BeWELL) study. J Behav Med 2021; 44:760-771. [PMID: 34159500 DOI: 10.1007/s10865-021-00235-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/05/2021] [Indexed: 10/21/2022]
Abstract
African American women with systemic lupus erythematosus (SLE) have worse disease outcomes compared to their White counterparts. Stressors associated with race may contribute to poorer health in this population through maladaptive behavioral pathways. This study investigated relationships between stress associated with anticipating racism, smoking, and SLE disease activity. Data were from 432 African American women with SLE in the Black Women's Experiences Living with Lupus (BeWELL) Study. Controlling for sociodemographic and health-related covariates, multivariable regression analyses revealed a significant association between anticipatory racism stress (ARS) and disease activity (p = 0.00, b = 1.13, 95% CI [0.43, 1.82]). A significant interaction between ARS and smoking also indicated that smoking exacerbated the effect of ARS on disease activity (p = 0.04, b = 1.95, CI = 0.04, 3.96). Test for evidence of smoking mediating the effect of ARS on disease activity were not statistically significant (z = 1.77, p = 0.08). Findings have implications for future SLE disparities research among African American women with SLE.
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Affiliation(s)
- Erica C Spears
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Amani M Allen
- Divisions of Community Health Sciences and Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Kara W Chung
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - Connor D Martz
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - Evelyn A Hunter
- Department of Special Education, Rehabilitation & Counseling, College of Education, Auburn University, Auburn, AL, USA
| | - Thomas E Fuller-Rowell
- Department of Human Development and Family Studies, College of Human Sciences, Auburn University, Auburn, AL, USA
| | - S Sam Lim
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christina Drenkard
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David H Chae
- Department of Global Community Health and Behavioral Science, School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA, USA
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Bhui K, Halvorsrud K, Mooney R, Hosang GM. Is psychosis a syndemic manifestation of historical and contemporary adversity? Findings from UK Biobank. Br J Psychiatry 2021; 219:686-694. [PMID: 35048874 PMCID: PMC8636607 DOI: 10.1192/bjp.2021.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/07/2021] [Accepted: 08/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Psychosis is associated with many forms of adversity, deprivation and living in urban areas. AIMS To investigate whether psychosis is part of a syndemic of multiple adversities. METHOD Drawing on UK Biobank (UKBB) data (Project ID: 57601), we sought to understand mechanisms by which childhood, recent/contemporary and place-based adversities might cluster and interact to be implicated in pathways by which psychoses evolve. We investigated the associations between adversities, potential mediating inflammatory markers and ICD-10 diagnoses (F20-F31) of psychotic disorders. We fitted logistic regression models initially including all relevant candidate variables and used backwards deletion to retain theoretically plausible and statistically significant (P < 0.05) associations with psychotic disorders. The candidate variables were entered in a partial least squares structural equation model (PLS-SEM) to test for syndemic interactions between risk factors. We tested whether the findings were sensitive to demographics, gender and ethnicity. RESULTS We fitted a PLS-SEM including psychosis as a syndemic outcome, and identified three latent constructs: lifetime adversity, current adversity and biomarkers. Factor loadings were above 0.30, and all structural paths were significant (P < 0.05). There were moderate associations between lifetime adversity and current adversity (standardised coefficient s.c. = 0.178) and between current adversity and biomarkers (s.c. = 0.227). All three latent constructs showed small but significant associations with psychosis (s.c. < 0.04). Lifetime adversity and current adversity were more strongly associated among ethnic minorities (combined) than White British people. CONCLUSIONS Our findings stress the importance of interactions between childhood and contemporary adversities in preventive and therapeutic interventions for psychotic disorders, especially among ethnic minorities.
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Affiliation(s)
- Kamaldeep Bhui
- Department of Psychiatry and Nuffield Department of Primary Care Health Sciences, University of Oxford; and Centre for Psychiatry, Queen Mary University of London, UK
| | - Kristoffer Halvorsrud
- National Institute of Health Research Applied Research Collaboration (NIHR ARC) North Thames, University College London; and Department of Psychiatry, University of Oxford, UK
| | | | - Georgina M. Hosang
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK
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93
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Zhou S, Gao L, Liu F, Tian W, Jin Y, Zheng ZJ. Socioeconomic status and depressive symptoms in older people with the mediation role of social support: A population-based longitudinal study. Int J Methods Psychiatr Res 2021; 30:e1894. [PMID: 34591341 PMCID: PMC8633935 DOI: 10.1002/mpr.1894] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/12/2021] [Accepted: 09/14/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Depressive symptoms has become an increasingly important public health issue, contributing to disability and disease burden around the world. Higher socioeconomic status (SES) has been found to be associated with lower prevalence of depression, but there are few studies about the older Chinese adults with long-term follow up and rigorous prospective design. Meanwhile, there is little conclusive evidence about the mechanisms through which SES influences the onset of depressive symptoms. OBJECTIVE To prospectively examine the association of baseline socioeconomic factors with the risks of developing depressive symptoms during 7-year follow up in older Chinese population, and to study the mechanism by which SES impacts the prevalence of depressive symptoms. METHODS A total of 5677 individuals over 45 years who participated in an ongoing nationally representative prospective cohort study, China Health and Retirement Longitudinal Study, were free from depressive symptoms at baseline, and completed 7-year follow-up were included. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale score. Cox proportional hazards regression models were used to examine the association of SES and the incidence of depressive symptoms in 2011 to 2018. Generalized structural equation model was used to analyze the mediation effects of social support on the relation between SES and depressive symptoms. RESULTS During the 7-year follow-up, 2398 (42.2%) cases were identified as depressive symptoms. Compared with the lowest level of household income, participants with the highest level of household income had a 20% reduction in risk (95% CI, 0.70-0.92, P < 0.001). Participants who had junior high school or above education had a 41% lower risk of depressive disorders compared with illiterate participants (95% CI, 0.52-0.69, P < 0.001). The relationship between SES and depressive symptoms was partially mediated by the social support, where higher social support was negatively associated with depressive symptoms. The proportion of mediation effect was even larger for women compared with men. CONCLUSION Socioeconomic factors were independently associated with the development of depressive symptoms, and the relationship was partially mediated by social support. Social support could be an effective intervention to alleviate the negative effects of lower SES on mental health. Multiple-level policies should precisely target low-SES groups, and timely intervention to promote social support for this group should be used to reduce the influence of depression on individuals, family as well as the whole society.
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Affiliation(s)
- Shuduo Zhou
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Liqun Gao
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Fangjing Liu
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Wenya Tian
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Yinzi Jin
- Department of Global Health, Peking University School of Public Health, Beijing, China
| | - Zhi-Jie Zheng
- Department of Global Health, Peking University School of Public Health, Beijing, China.,Institute for Global Health and Development, Peking University, Beijing, China
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94
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Crielaard L, Nicolaou M, Sawyer A, Quax R, Stronks K. Understanding the impact of exposure to adverse socioeconomic conditions on chronic stress from a complexity science perspective. BMC Med 2021; 19:242. [PMID: 34635083 PMCID: PMC8507143 DOI: 10.1186/s12916-021-02106-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Chronic stress increases chronic disease risk and may underlie the association between exposure to adverse socioeconomic conditions and adverse health outcomes. The relationship between exposure to such conditions and chronic stress is complex due to feedback loops between stressor exposure and psychological processes, encompassing different temporal (acute stress response to repeated exposure over the life course) and spatial (biological/psychological/social) scales. We examined the mechanisms underlying the relationship between exposure to adverse socioeconomic conditions and chronic stress from a complexity science perspective, focusing on amplifying feedback loops across different scales. METHODS We developed a causal loop diagram (CLD) to interpret available evidence from this perspective. The CLD was drafted by an interdisciplinary group of researchers. Evidence from literature was used to confirm/contest the variables and causal links included in the conceptual framework and refine their conceptualisation. Our findings were evaluated by eight independent researchers. RESULTS Adverse socioeconomic conditions imply an accumulation of stressors and increase the likelihood of exposure to uncontrollable childhood and life course stressors. Repetition of such stressors may activate mechanisms that can affect coping resources and coping strategies and stimulate appraisal of subsequent stressors as uncontrollable. We identified five feedback loops describing these mechanisms: (1) progressive deterioration of access to coping resources because of repeated insolvability of stressors; (2) perception of stressors as uncontrollable due to learned helplessness; (3) tax on cognitive bandwidth caused by stress; (4) stimulation of problem avoidance to provide relief from the stress response and free up cognitive bandwidth; and (5) susceptibility to appraising stimuli as stressors against a background of stress. CONCLUSIONS Taking a complexity science perspective reveals that exposure to adverse socioeconomic conditions implies recurrent stressor exposure which impacts chronic stress via amplifying feedback loops that together could be conceptualised as one vicious cycle. This means that in order for individual-level psychological interventions to be effective, the context of exposure to adverse socioeconomic conditions also needs to be addressed.
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Affiliation(s)
- Loes Crielaard
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
- Institute for Advanced Study, University of Amsterdam, Amsterdam, 1012 GC, The Netherlands.
| | - Mary Nicolaou
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Institute for Advanced Study, University of Amsterdam, Amsterdam, 1012 GC, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, 1012 GC, The Netherlands
| | - Alexia Sawyer
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Rick Quax
- Institute for Advanced Study, University of Amsterdam, Amsterdam, 1012 GC, The Netherlands
- Computational Science Lab, University of Amsterdam, Amsterdam, 1098 XH, The Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
- Institute for Advanced Study, University of Amsterdam, Amsterdam, 1012 GC, The Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, 1012 GC, The Netherlands
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95
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Goreis A, Nater UM, Mewes R. Effects of chronic ethnic discrimination in the daily life of Turkish immigrants living in Austria: study protocol of a 30-day ambulatory assessment study. BMJ Open 2021; 11:e046697. [PMID: 34620655 PMCID: PMC8499268 DOI: 10.1136/bmjopen-2020-046697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Chronic ethnic discrimination is associated with negative mental and physical health outcomes in ethnic minority groups. It is assumed that suffering from repeated discriminatory events leads, over time, to psychological consequences such as higher perceived stress, higher negative affect and lower positive affect. Higher stress reactivity to non-discriminatory stressors, such as daily hassles, as well as anticipation and avoidance behaviour regarding discriminatory events, may further contribute to the overall burden for affected individuals. Studies investigating chronic ethnic discrimination and its psychological consequences in the daily lives of affected persons are lacking. Here, we present a study protocol to investigate the impact of chronic ethnic discrimination and acute discriminatory events in the daily lives of Turkish immigrants living in Austria, using an ambulatory assessment design. The feasibility of our study design was tested and confirmed in a pilot study (n=10). METHODS AND ANALYSIS Ninety male Turkish immigrants will complete daily questionnaires for 30 days. Participants will indicate stress, perceived discrimination, negative and positive affect, daily hassles, anticipation and avoidance behaviour, as well as rumination with regard to discriminatory events on a daily basis. Furthermore, they will use preprogrammed iPods to assess acute discriminatory events in real time. Our hypotheses will be tested using multilevel analyses. ETHICS AND DISSEMINATION This study has been approved by the institutional review board of the University of Vienna (reference number 00358). Results will be presented at conferences and submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Andreas Goreis
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Urs M Nater
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
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96
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The emotional and mental health impact of the murder of George Floyd on the US population. Proc Natl Acad Sci U S A 2021; 118:2109139118. [PMID: 34544875 DOI: 10.1073/pnas.2109139118] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
On May 25, 2020, George Floyd, an unarmed Black American male, was killed by a White police officer. Footage of the murder was widely shared. We examined the psychological impact of Floyd's death using two population surveys that collected data before and after his death; one from Gallup (117,568 responses from n = 47,355) and one from the US Census (409,652 responses from n = 319,471). According to the Gallup data, in the week following Floyd's death, anger and sadness increased to unprecedented levels in the US population. During this period, more than a third of the US population reported these emotions. These increases were more pronounced for Black Americans, nearly half of whom reported these emotions. According to the US Census Household Pulse data, in the week following Floyd's death, depression and anxiety severity increased among Black Americans at significantly higher rates than that of White Americans. Our estimates suggest that this increase corresponds to an additional 900,000 Black Americans who would have screened positive for depression, associated with a burden of roughly 2.7 million to 6.3 million mentally unhealthy days.
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97
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Miyamoto Y, Ryff CD. Culture and Health: Recent Developments and Future Directions
1. JAPANESE PSYCHOLOGICAL RESEARCH 2021; 64:90-108. [PMID: 35509718 PMCID: PMC9060271 DOI: 10.1111/jpr.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Evidence of cultural differences in relationships and emotions has accumulated over the past few decades. As findings on cultural differences in psychological processes have accumulated, there has been growing interest in investigating whether they have implications for other phenomena such as health. Using scientific advances from the MIDUS and MIDJA studies, both publicly available, we examine links between culture and health. We first briefly review the accumulated evidence on cultural influences on health correlates of psychosocial factors. We then feature two recent developments - a more micro-level perspective on biological factors that may be involved in the culture and health linkage, and a more macro-level view of socioeconomic inequality, which also matters for health. Both perspectives inform the pathways through which health effects occur. Finally, we conclude our review by highlighting the changing historical contexts surrounding these cross-cultural investigations. Specifically, we draw attention to widening of economic inequality across cultures and the world-wide COVID-19 pandemic. These happenings bring notable implications for future research on health across cultural contexts.
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98
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Liu C, Cao W, Meng X, Shen J, Liang X, Guo Y, Tang K. The Role of Interpersonal Relationships and Household Socioeconomic Status in the Association Between Sexual Orientation and Health: A Moderated Mediation Analysis. LGBT Health 2021; 8:554-562. [PMID: 34558972 DOI: 10.1089/lgbt.2020.0320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Emerging studies indicate that sexual minority youths experience worse health than their heterosexual peers, but few studies have examined the intervening mechanisms linking sexual orientation and health status. This study hypothesizes that interpersonal relationships, moderated by household socioeconomic status (HSES), are important mediators in the association between sexual orientation and health status. Methods: A total of 49,084 youths, consisting of 9499 youths who identified as sexual minority individuals and 39,585 youths who identified as heterosexual, were sampled from a national study on sexual and reproductive health conducted in China. Logistic regression analyses were performed to estimate the association between sexual orientation and self-rated health. Causal mediation and moderated mediation analyses were performed to analyze the mediating and moderating effects of interpersonal relationships and HSES, respectively. Results: Self-rated health was significantly poorer for sexual minority youths compared with heterosexual youths (p < 0.01). From 7.90% to 25.74% of the association between sexual orientation and self-rated health was mediated through poor interpersonal relationships with both parents and peers. A poor relationship with the father accounted for the highest percentage. HSES was found to moderate the mediation effect of interpersonal relationships, with the greatest effect found for sexual minority youths with lower HSES. Conclusion: HSES moderated the indirect effects of interpersonal relationships on the association between sexual orientation and self-rated health. Interventions focused on improving interpersonal relationships for sexual minority youths, especially those with low HSES, merit attention.
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Affiliation(s)
- Chunyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, P.R. China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P.R. China
| | - Wenzhen Cao
- Vanke School of Public Health, Tsinghua University, Beijing, P.R. China.,Department of Information Management, Peking University, Beijing, P.R. China
| | - Xiangrui Meng
- Vanke School of Public Health, Tsinghua University, Beijing, P.R. China
| | - Jiashu Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P.R. China
| | - Xiao Liang
- China Family Planning Association, Beijing, P.R. China
| | - Yueping Guo
- School of Journalism and Communication, Graduate School of Chinese Academy of Social Sciences, Beijing, P.R. China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, P.R. China
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Werber T, Bata Z, Vaszine ES, Berente DB, Kamondi A, Horvath AA. The Association of Periodontitis and Alzheimer's Disease: How to Hit Two Birds with One Stone. J Alzheimers Dis 2021; 84:1-21. [PMID: 34511500 DOI: 10.3233/jad-210491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Alzheimer's disease (AD) is the leading cause of cognitive impairment in the elderly. Recent evidence suggests that preventive interventional trials could significantly reduce the risk for development of dementia. Periodontitis is the most common dental disease characterized by chronic inflammation and loss of alveolar bone and perialveolar attachment of teeth. Growing number of studies propose a potential link between periodontitis and neurodegeneration. In the first part of the paper, we overview case-control studies analyzing the prevalence of periodontitis among AD patients and healthy controls. Second, we survey observational libraries and cross-sectional studies investigating the risk of cognitive decline in patients with periodontitis. Next, we describe the current view on the mechanism of periodontitis linked neural damage, highlighting bacterial invasion of neural tissue from dental plaques, and periodontitis induced systemic inflammation resulting in a neuroinflammatory process. Later, we summarize reports connecting the four most common periodontal pathogens to AD pathology. Finally, we provide a practical guide for further prevalence and interventional studies on the management of cognitively high-risk patients with and without periodontitis. In this section, we highlight strategies for risk control, patient information, dental evaluation, reporting protocol and dental procedures in the clinical management of patients with a risk for periodontitis and with diagnosed periodontitis. In conclusion, our review summarizes the current view on the association between AD and periodontitis and provides a research and intervention strategy for harmonized interventional trials and for further case-control or cross-sectional studies.
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Affiliation(s)
- Tom Werber
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsofia Bata
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Eniko Szabo Vaszine
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Dalida Borbala Berente
- Faculty of Medicine, Semmelweis University, Budapest, Hungary.,Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Anita Kamondi
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Andras Attila Horvath
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
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Jones DP, Wootton RE, Gill D, Carter AR, Gunnell D, Munafò MR, Sallis HM. Mental Health as a Mediator of the Association Between Educational Inequality and Cardiovascular Disease: A Mendelian Randomization Study. J Am Heart Assoc 2021; 10:e019340. [PMID: 34472355 PMCID: PMC8649303 DOI: 10.1161/jaha.120.019340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/26/2021] [Indexed: 11/16/2022]
Abstract
Background Education is inversely associated with cardiovascular disease (CVD). Several mediators of this have been established; however, a proportion of the protective effect remains unaccounted for. Mental health is a proposed mediator, but current evidence is mixed and subject to bias from confounding factors and reverse causation. Mendelian randomization is an instrumental variable technique that uses genetic proxies for exposures and mediators to reduce such bias. Methods and Results We performed logistic regression and 2-step Mendelian randomization analyses using UK Biobank data and genetic summary statistics to investigate whether educational attainment affects risk of mental health disorders. We then performed mediation analyses to explore whether mental health disorders mediate the association between educational attainment and cardiovascular risk. Higher levels of educational attainment were associated with reduced depression, anxiety, and CVD in observational analyses (odds ratio [OR], 0.79 [95% CI, 0.77-0.81], 0.76 [95% CI, 0.73-0.79], and 0.75 [95% CI, 0.74-0.76], respectively), and Mendelian randomization analyses provided evidence of causality (OR, 0.72 [95% CI, 0.67-0.77], 0.50 [95% CI, 0.42-0.59], and 0.62 [95% CI, 0.58-0.66], respectively). Both anxiety and depression were associated with CVD in observational analyses (OR, 1.63 [95% CI, 1.49-1.79] and 1.70 [95% CI, 1.59-1.82], respectively) but only depression showed evidence of causality in the Mendelian randomization analyses (OR, 1.09; 95% CI, 1.03-1.15). An estimated 2% of the total protective effect of education on CVD was mediated by depression. Conclusions Higher levels of educational attainment protect against mental health disorders, and reduced depression accounts for a small proportion of the total protective effect of education on CVD.
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Affiliation(s)
- Daniel P. Jones
- Department of Population Health SciencesBristol Medical SchoolUniversity of BristolUK
- Division of Population MedicineSchool of MedicineCardiff UniversityUK
| | - Robyn E. Wootton
- Department of Population Health SciencesBristol Medical SchoolUniversity of BristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolOakfield HouseBristolUK
| | - Dipender Gill
- Department of Epidemiology and BiostatisticsImperial College LondonLondonUK
- Clinical Pharmacology and Therapeutics SectionInstitute of Medical and Biomedical Education and Institute for Infection and ImmunitySt George’sUniversity of LondonUK
| | - Alice R. Carter
- Department of Population Health SciencesBristol Medical SchoolUniversity of BristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolOakfield HouseBristolUK
| | - David Gunnell
- Department of Population Health SciencesBristol Medical SchoolUniversity of BristolUK
- NIHR Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation TrustUniversity of BristolUK
| | - Marcus R. Munafò
- MRC Integrative Epidemiology UnitUniversity of BristolOakfield HouseBristolUK
- NIHR Biomedical Research Centre at the University Hospitals Bristol and Weston NHS Foundation TrustUniversity of BristolUK
- School of Psychological ScienceUniversity of BristolUK
| | - Hannah M. Sallis
- Department of Population Health SciencesBristol Medical SchoolUniversity of BristolUK
- MRC Integrative Epidemiology UnitUniversity of BristolOakfield HouseBristolUK
- School of Psychological ScienceUniversity of BristolUK
- Centre for Academic Mental HealthPopulation Health SciencesBristol Medical SchoolUniversity of BristolUK
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