1
|
Sun F, Yao J, Du S, Qian F, Appleton AA, Tao C, Xu H, Liu L, Dai Q, Joyce BT, Nannini DR, Hou L, Zhang K. Social Determinants, Cardiovascular Disease, and Health Care Cost: A Nationwide Study in the United States Using Machine Learning. J Am Heart Assoc 2023; 12:e027919. [PMID: 36802713 PMCID: PMC10111459 DOI: 10.1161/jaha.122.027919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background Existing studies on cardiovascular diseases (CVDs) often focus on individual-level behavioral risk factors, but research examining social determinants is limited. This study applies a novel machine learning approach to identify the key predictors of county-level care costs and prevalence of CVDs (including atrial fibrillation, acute myocardial infarction, congestive heart failure, and ischemic heart disease). Methods and Results We applied the extreme gradient boosting machine learning approach to a total of 3137 counties. Data are from the Interactive Atlas of Heart Disease and Stroke and a variety of national data sets. We found that although demographic composition (eg, percentages of Black people and older adults) and risk factors (eg, smoking and physical inactivity) are among the most important predictors for inpatient care costs and CVD prevalence, contextual factors such as social vulnerability and racial and ethnic segregation are particularly important for the total and outpatient care costs. Poverty and income inequality are the major contributors to the total care costs for counties that are in nonmetro areas or have high segregation or social vulnerability levels. Racial and ethnic segregation is particularly important in shaping the total care costs for counties with low poverty rates or social vulnerability level. Demographic composition, education, and social vulnerability are consistently important across different scenarios. Conclusions The findings highlight the differences in predictors for different types of CVD cost outcomes and the importance of social determinants. Interventions directed toward areas that have been economically and socially marginalized may aid in reducing the impact of CVDs.
Collapse
Affiliation(s)
- Feinuo Sun
- Global Aging and Community Initiative Mount Saint Vincent University Halifax Nova Scotia Canada
| | - Jie Yao
- Department of Epidemiology and Biostatistics, School of Public Health University at Albany, State University of New York Albany NY
| | - Shichao Du
- Department of Sociology University at Albany, State University of New York Albany NY
| | - Feng Qian
- Department of Health Policy, Management and Behavior, School of Public Health University at Albany, State University of New York Albany NY
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, School of Public Health University at Albany, State University of New York Albany NY
| | - Cui Tao
- School of Biomedical Informatics The University of Texas Health Science Center at Houston Houston TX
| | - Hua Xu
- School of Biomedical Informatics The University of Texas Health Science Center at Houston Houston TX
| | - Lei Liu
- Division of Biostatistics Washington University in St. Louis St. Louis MO
| | - Qi Dai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, School of Medicine Vanderbilt University, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center Nashville TN
| | - Brian T Joyce
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Drew R Nannini
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Lifang Hou
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health University at Albany, State University of New York Albany NY
| |
Collapse
|
2
|
Luo J, Chen X, Tindle H, Shadyab AH, Saquib N, Hale L, Garcia L, Springfield S, Liu B, Nassir R, Snetselaar L, Hendryx M. Do health behaviors mediate associations between personality traits and diabetes incidence? Ann Epidemiol 2020; 53:7-13.e2. [PMID: 32805399 DOI: 10.1016/j.annepidem.2020.08.007] [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: 02/27/2020] [Revised: 07/17/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Personality traits have been reported to be associated with type 2 diabetes (T2DM) risk. The objective of this study was to examine whether and to what extent the associations between personality traits (dispositional optimism, hostility, and negative emotional expressiveness) and risk of T2DM were mediated by health behaviors and obesity. METHODS Postmenopausal women (n = 110,992) aged 50-79 years without diabetes at enrollment in the Women's Health Initiative study (1993-1998) were followed up to 25 years. Incident diabetes was assessed via a validated self-report of physician-diagnosed diabetes treated with insulin or other hypoglycemic medications. Mediation analyses were performed using approaches under a counterfactual framework. RESULTS An inverse association of optimism with diabetes was significantly mediated by a factor primarily extracted from physical activity, diet quality, and sleep quality with a mediated proportion of 28%. Positive associations for hostility and negative emotional expressiveness were substantially mediated by a factor primarily composed of body mass index and waist circumference with mediated proportions of 32% and 44%, respectively. CONCLUSIONS Our data revealed that less than half of the associations between personality traits and risk of T2DM were explained by indirect health behavior pathways. Women's personality traits should be considered in prevention of diabetes in addition to promoting health behaviors.
Collapse
Affiliation(s)
- Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN.
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, IN
| | - Hilary Tindle
- Department of Medicine, Vanderbilt Univeristy, Nashville, TN
| | - Aladdin H Shadyab
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla
| | - Nazmus Saquib
- Research Unit, College of Medicine, Sulaiman AlRajhi University, Saudi Arabia
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, School of Medicine, Stony Brook University, NY
| | - Lorena Garcia
- Department of Public Health Sciences, School of Medicine University of California, Davis
| | - Sparkle Springfield
- Department of Public Health, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, IA
| | - Rami Nassir
- Department of Pathology, School of Medicine, Umm Al-Qura University, Saudi Arabia
| | - Linda Snetselaar
- Department of Epidemiology, College of Public Health, Univeristy of Iowa, IA
| | - Michael Hendryx
- Department of Environmental and Occupational Health, School of Public Health, Indiana University Bloomington, Bloomington, IN
| |
Collapse
|
3
|
Abstract
OBJECTIVE We examined whether personality traits, including optimism, ambivalence over emotional expressiveness, negative emotional expressiveness, and hostility, were associated with risk of developing type 2 diabetes (hereafter diabetes) among postmenopausal women. METHODS A total of 139,924 postmenopausal women without diabetes at baseline (between 1993 and 1998) aged 50 to 79 years from the Women's Health Initiative were prospectively followed for a mean of 14 (range 0.1-23) years. Multivariable Cox proportional hazards regression models were used to assess associations between personality traits and diabetes incidence adjusting for common demographic factors, health behaviors, and depressive symptoms. Personality traits were gathered at baseline using questionnaires. Diabetes during follow-up was assessed via self-report of physician-diagnosed treated diabetes. RESULTS There were 19,240 cases of diabetes during follow-up. Compared with women in the lowest quartile of optimism (least optimistic), women in the highest quartile (most optimistic) had 12% (hazard ratio [HR], 0.88; 95% confidence interval [CI]: 0.84-0.92) lower risk of incident diabetes. Compared with women in the lowest quartile for negative emotional expressiveness or hostility, women in the highest quartile had 9% (HR, 1.09; 95% CI: 1.05-1.14) and 17% (HR, 1.17; 95% CI: 1.12-1.23) higher risk of diabetes, respectively. The association of hostility with risk of diabetes was stronger among nonobese than obese women. CONCLUSIONS Low optimism and high NEE and hostility were associated with increased risk of incident diabetes among postmenopausal women independent of major health behaviors and depressive symptoms. In addition to efforts to promote healthy behaviors, women's personality traits should be considered to guide clinical or programmatic intervention strategies in diabetes prevention.
Collapse
|
4
|
Progovac AM, Pettinger M, Donohue JM, Chang CCH(J, Matthews KA, Habermann EB, Kuller LH, Rosal M, Li W, Garcia L, Tindle HA. Optimism may moderate screening mammogram frequency in Medicare: A longitudinal study. Medicine (Baltimore) 2019; 98:e15869. [PMID: 31192918 PMCID: PMC6587654 DOI: 10.1097/md.0000000000015869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Higher trait optimism and/or lower cynical hostility are associated with healthier behaviors and lower risk of morbidity and mortality, yet their association with health care utilization has been understudied. Whether these psychological attitudes are associated with breast cancer screening behavior is unknown. To assess the association of optimism and cynical hostility with screening mammography in older women and whether sociodemographic factors acted as mediators of these relationships, we used Women's Health Initiative (WHI) observational cohort survey data linked to Medicare claims. The sample includes WHI participants without history of breast cancer who were enrolled in Medicare Parts A and B for ≥2 years from 2005-2010, and who completed WHI baseline attitudinal questionnaires (n = 48,291). We used survival modeling to examine whether screening frequency varied by psychological attitudes (measured at study baseline) after adjusting for sociodemographic characteristics, health conditions, and healthcare-related variables. Psychological attitudes included trait optimism (Life Orientation Test-Revised) and cynical hostility (Cook Medley subscale), which were self-reported at study baseline. Sociodemographic, health conditions, and healthcare variables were self-reported at baseline and updated through 2005 as available. Contrary to our hypotheses, repeated events survival models showed that women with the lowest optimism scores (i.e., more pessimistic tendencies) received 5% more frequent screenings after complete covariate adjustment (p < .01) compared to the most optimistic group, and showed no association between cynical hostility and frequency of screening mammograms. Sociodemographic factors did not appear to mediate the relationship between optimism and screenings. However, higher levels of education and higher levels of income were associated with more frequent screenings (both p < .01). We also found that results for optimism were primarily driven by women who were aged 75 or older after January 2009, when changes to clinical guidelines lead to uncertainty about risks and benefits of screening in this age group. The study demonstrated that lower optimism, higher education, and higher income were all associated with more frequent screening mammograms in this sample after repeated events survival modeling and covariate adjustment.
Collapse
Affiliation(s)
- Ana M. Progovac
- Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, Cambridge
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Julie M. Donohue
- Department of Health Policy and Management, University of Pittsburgh School of Public Health
| | | | - Karen A. Matthews
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Lewis H. Kuller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
| | - Milagros Rosal
- Department of Quantitative Health Sciences, University of Massachusetts Medical School
| | - Wenjun Li
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Lorena Garcia
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA
| | - Hilary A. Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN
| |
Collapse
|
5
|
Psychological Traits, Heart Rate Variability, and Risk of Coronary Heart Disease in Healthy Aging Women-The Women's Health Initiative. Psychosom Med 2019; 81:256-264. [PMID: 30688770 PMCID: PMC6443472 DOI: 10.1097/psy.0000000000000672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Psychological traits such as optimism and hostility affect coronary heart disease (CHD) risk, but mechanisms for this association are unclear. We hypothesized that optimism and hostility may affect CHD risk via changes in heart rate variability (HRV). METHODS We conducted a longitudinal analysis using data from the Women's Health Initiative Myocardial Ischemia and Migraine Study. Participants underwent 24-hour ambulatory electrocardiogram monitoring 3 years after enrollment. Optimism (Life Orientation Test-Revised), cynical hostility (Cook-Medley), demographics, and coronary risk factors were assessed at baseline. HRV measures included standard deviation of average N-N intervals (SDNN); standard deviation of average N-N intervals for 5 minutes (SDANN); and average heart rate (HR). CHD was defined as the first occurrence of myocardial infarction, angina, coronary angioplasty, and bypass grafting. Linear and Cox regression models adjusted for CHD risk factors were used to examine, respectively, associations between optimism, hostility, and HRV and between HRV and CHD risk. RESULTS Final analyses included 2655 women. Although optimism was not associated with HRV, hostility was inversely associated with HRV 3 years later (SDANN: adjusted β = -0.54; 95% CI = -0.97 to -0.11; SDNN: -0.49; 95% CI = -0.93 to -0.05). HRV was inversely associated with CHD risk; for each 10-millisecond increase in SDNN or SDANN, there was a decrease in CHD risk of 9% (p = .023) and 12% (p = .006), respectively. CONCLUSIONS HRV did not play a major role in explaining why more optimistic women seem to be somewhat protected from CHD risk. Although hostility was inversely associated with HRV, its role in explaining the association between hostility and CHD risk remains to be established.
Collapse
|
6
|
Optimists report fewer physical and mental health conditions than pessimists in the general Norwegian population. HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.81003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
7
|
CLINICAL-PSYCHOLOGICAL REHABILITATION OF CARDIAC PATIENTS THROUGH OPTMIZATION OF THE SELF-PERCEPTION OF HEALTH. WORLD OF MEDICINE AND BIOLOGY 2019. [DOI: 10.26724/2079-8334-2019-4-70-122-127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
8
|
Tindle HA, Duncan MS, Liu S, Kuller LH, Fugate Woods N, Rapp SR, Kroenke CH, Coday M, Loucks EB, Lamonte MJ, Progovac AM, Salmoirago-Blotcher E, Walitt BT, Yuo NCY, Freiberg MS. Optimism, pessimism, cynical hostility, and biomarkers of metabolic function in the Women's Health Initiative. J Diabetes 2018; 10:512-523. [PMID: 28703425 PMCID: PMC8835287 DOI: 10.1111/1753-0407.12584] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 06/20/2017] [Accepted: 07/05/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Psychological attitudes reflecting expectations about the future (optimism, pessimism) and people (cynical hostility) independently predict incident cardiovascular disease and possibly diabetes, but underlying biologic pathways are incompletely understood. Herein we examined the cross-sectional relationship between optimism, pessimism, and cynicism and biomarkers of metabolic function in the Women's Health Initiative. METHODS Among 3443 postmenopausal women, biomarkers of metabolic function (fasting insulin [FINS] and glucose) were measured at baseline and used to calculate insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) and pancreatic β-cell activity (homeostasis model assessment of β-cell function [HOMA-B]). Psychological attitudes were assessed by the Life Orientation Test, Revised (full scale, and optimism and pessimism subscales) and the Cook-Medley cynicism subscale. Multivariable linear regression modeled the association of psychological attitudes with biomarker levels, adjusting for sociodemographics, health conditions, and health behaviors. Because obesity promotes insulin resistance and obese individuals tend to report higher levels of pessimism and cynical hostility, an interaction with body mass index (BMI) was explored. RESULTS In fully adjusted models, only pessimism remained independently associated with higher FINS and insulin resistance (HOMA-IR). Scoring 1 point higher on the pessimism subscale was associated with a 1.2% higher FINS, whereas scoring 1 SD higher was associated with a 2.7% higher FINS (P = 0.03); results were similar for HOMA-IR. An interaction term with BMI was not significant. CONCLUSIONS In multivariable models, higher dispositional pessimism was associated with worse metabolic function; these findings were not modified by obesity status. Results extend prior work by linking pessimism to an objective biomarker of insulin resistance in elderly women.
Collapse
Affiliation(s)
- Hilary A Tindle
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Simin Liu
- Brown University, Providence, Rhode Island, USA
| | | | | | - Steve R Rapp
- Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, North Carolina, USA
| | | | - Mace Coday
- University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Huffman JC, Mastromauro CA, Boehm JK, Seabrook R, Fricchione GL, Denninger JW, Lyubomirsky S. Development of a Positive Psychology Intervention for Patients with Acute Cardiovascular Disease. Heart Int 2018. [DOI: 10.4081/hi.2011.e13a] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jeff C. Huffman
- Harvard Medical School, Boston, MA
- Department of Psychiatry Massachusetts General Hospital, Boston, MA
| | | | | | - Rita Seabrook
- Department of Psychiatry Massachusetts General Hospital, Boston, MA
| | - Gregory L. Fricchione
- Harvard Medical School, Boston, MA
- Department of Psychiatry Massachusetts General Hospital, Boston, MA
- Benson Henry Institute for Mind Body Medicine, Boston, MA
| | - John W. Denninger
- Harvard Medical School, Boston, MA
- Department of Psychiatry Massachusetts General Hospital, Boston, MA
- Benson Henry Institute for Mind Body Medicine, Boston, MA
| | - Sonja Lyubomirsky
- Department of Psychology, University of California at Riverside, CA, USA
| |
Collapse
|
10
|
Kollia N, Panagiotakos D, Georgousopoulou E, Chrysohoou C, Yannakoulia M, Stefanadis C, Chatterji S, Haro JM, Papageorgiou C, Pitsavos C. Exploring the path between depression, anxiety and 10-year cardiovascular disease incidence, among apparently healthy Greek middle-aged adults: The ATTICA study. Maturitas 2017; 106:73-79. [PMID: 29150168 DOI: 10.1016/j.maturitas.2017.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/10/2017] [Accepted: 09/15/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Although there is substantial evidence that psychological factors play an important role in the onset and course of cardiovascular disease (CVD), less is known about their combined effect and the pathways by which they affect cardiovascular health. The present work aimed to prospectively explore the effects of depression and anxiety on the 10-year CVD incidence, in relation to other lifestyle determinants, as linking factors in the context of the ATTICA study. Study design/Main outcome measures: The ATTICA study is a population-based, health and nutrition prospective cohort study (2002-2012), during which 853 middle-aged participants without a history of CVD [453 men (aged 45±13years) and 400 women (aged 44±18years)], underwent psychological evaluations at enrollment. The latent trait of depression and anxiety combined measure was estimated and referred as "Psychological distress"; path analysis was applied to describe the relationships among the different factors. RESULTS "Psychological distress" was positively associated with the 10-year CVD incidence (adjusted OR per 10 units: 1.4, 95% CI: 1.1, 1.7). Three linking pathways were revealed: sedentariness, inflammation and metabolic syndrome. Moreover, "Psychological distress" mediated the association between socioeconomic status (SES) and CVD, with participants of low SES scoring higher on the psychological measure (adjusted linear regression coefficient b: -7.1, 95% CI: -9.7, -4.5). CONCLUSIONS Lifestyle and clinical factors seem to link psychological distress with CVD development. Joint psychological assessments should be considered for inclusion in CVD preventive strategies, which should incorporate interventions for interrupting the linking pathways.
Collapse
Affiliation(s)
- Natasa Kollia
- Department of Science of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Science of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Athens, Greece.
| | - Ekavi Georgousopoulou
- Department of Science of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Science of Dietetics and Nutrition, School of Health Science and Education, Harokopio University, Athens, Greece
| | | | - Somnath Chatterji
- Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
| | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | |
Collapse
|
11
|
Kim J, Kim O. A Health Behavior Prediction Model for Patients With Coronary Artery Disease. Clin Nurs Res 2017; 28:217-234. [DOI: 10.1177/1054773817725868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of this study was to determine the relationships among functional status, hostility, social support, illness perceptions, and health behaviors in patients with coronary artery disease using structural equation modeling. Participants comprised 215 patients with coronary artery disease who had received percutaneous coronary artery intervention or a coronary artery bypass graft in two general hospitals in Seoul, Korea. Using structured interviews with questionnaires, data accrued from July to August, 2015. Fitness of the model was verified with AMOS 21.0. As social support increased, it negatively aligned with cognitive-illness perceptions. Higher levels of hostility and greater negative cognitive-illness perceptions aligned with negative emotional-illness perceptions. Social support indirectly affected emotional-illness perceptions. Lower levels of functional status, greater social support, and more positive cognitive-illness perceptions aligned with health behaviors. Social support indirectly affected health behaviors. In conclusion, nurses should focus on coronary artery disease patients’ physical functions and cognitive-illness perceptions to provide support.
Collapse
Affiliation(s)
- Jiyoung Kim
- Dong-eui University, Busan, Republic of Korea
| | - Oksoo Kim
- Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
12
|
Progovac AM, Chang YF, Chang CCH, Matthews KA, Donohue JM, Scheier MF, Habermann EB, Kuller LH, Goveas JS, Chapman BP, Duberstein PR, Messina CR, Weaver KE, Saquib N, Wallace RB, Kaplan RC, Calhoun D, Smith JC, Tindle HA. Are Optimism and Cynical Hostility Associated with Smoking Cessation in Older Women? Ann Behav Med 2017; 51:500-510. [PMID: 28194642 PMCID: PMC5554747 DOI: 10.1007/s12160-016-9873-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Optimism and cynical hostility independently predict morbidity and mortality in Women's Health Initiative (WHI) participants and are associated with current smoking. However, their association with smoking cessation in older women is unknown. PURPOSE The purpose of this study is to test whether optimism (positive future expectations) or cynical hostility (mistrust of others) predicts smoking cessation in older women. METHODS Self-reported smoking status was assessed at years 1, 3, and 6 after study entry for WHI baseline smokers who were not missing optimism or cynical hostility scores (n = 10,242). Questionnaires at study entry assessed optimism (Life Orientation Test-Revised) and cynical hostility (Cook-Medley, cynical hostility subscale). Generalized linear mixed models adjusted for sociodemographics, lifestyle factors, and medical and psychosocial characteristics including depressive symptoms. RESULTS After full covariate adjustment, optimism was not related to smoking cessation. Each 1-point increase in baseline cynical hostility score was associated with 5% lower odds of cessation over 6 years (OR = 0.95, CI = 0.92-0.98, p = 0.0017). CONCLUSIONS In aging postmenopausal women, greater cynical hostility predicts lower smoking cessation over time. Future studies should examine whether individuals with this trait may benefit from more intensive cessation resources or whether attempting to mitigate cynical hostility itself may aid smoking cessation.
Collapse
Affiliation(s)
- Ana M Progovac
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
- Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, 1035 Cambridge St. Suite 26, Cambridge, MA, 02141, USA.
| | - Yue-Fang Chang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chung-Chou H Chang
- Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Julie M Donohue
- Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Michael F Scheier
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Elizabeth B Habermann
- Division of Health Care Policy & Research and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - Lewis H Kuller
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Benjamin P Chapman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Public Health Sciences, University of Rochester Medical Medical Center, Rochester, NY, USA
| | - Paul R Duberstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Catherine R Messina
- Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman Al Rajhi Colleges, Al-Qassim, Kingdom of Saudi Arabia
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | | | - J Carson Smith
- Department of Kinesiology, University of Maryland School of Public Health, College Park, MD, USA
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| |
Collapse
|
13
|
Affiliation(s)
- Margaretha Viljoen
- Department of Psychiatry, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Nicolaas Claassen
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
14
|
Cauley JA, Smagula SF, Hovey KM, Wactawski-Wende J, Andrews CA, Crandall CJ, LeBoff MS, Li W, Coday M, Sattari M, Tindle HA. Optimism, Cynical Hostility, Falls, and Fractures: The Women's Health Initiative Observational Study (WHI-OS). J Bone Miner Res 2017; 32:221-229. [PMID: 27566996 PMCID: PMC7079733 DOI: 10.1002/jbmr.2984] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/16/2016] [Accepted: 08/25/2016] [Indexed: 11/10/2022]
Abstract
Traits of optimism and cynical hostility are features of personality that could influence the risk of falls and fractures by influencing risk-taking behaviors, health behaviors, or inflammation. To test the hypothesis that personality influences falls and fracture risk, we studied 87,342 women enrolled in WHI-OS. Optimism was assessed by the Life Orientation Test-Revised and cynical hostility, the cynicism subscale of the Cook-Medley questionnaire. Higher scores indicate greater optimism and hostility. Optimism and hostility were correlated at r = -0. 31, p < 0.001. Annual self-report of falling ≥2 times in the past year was modeled using repeated measures logistic regression. Cox proportional hazards models were used for the fracture outcomes. We examined the risk of falls and fractures across the quartiles (Q) of optimism and hostility with tests for trends; Q1 formed the referent group. The average follow-up for fractures was 11.4 years and for falls was 7.6 years. In multivariable (MV)-adjusted models, women with the highest optimism scores (Q4) were 11% less likely to report ≥2 falls in the past year (odds ratio [OR] = 0.89; 95% confidence intervals [CI] 0.85-0.90). Women in Q4 for hostility had a 12% higher risk of ≥2 falls (OR = 1.12; 95% CI 1.07-1.17). Higher optimism scores were also associated with a 10% lower risk of fractures, but this association was attenuated in MV models. Women with the greatest hostility (Q4) had a modest increased risk of any fracture (MV-adjusted hazard ratio = 1. 05; 95% CI 1.01-1.09), but there was no association with specific fracture sites. In conclusion, optimism was independently associated with a decreased risk of ≥2 falls, and hostility with an increased risk of ≥2 falls, independent of traditional risk factors. The magnitude of the association was similar to aging 5 years. Whether interventions aimed at attitudes could reduce fall risks remains to be determined. © 2016 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Wenjun Li
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Mace Coday
- The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Maryam Sattari
- University of Florida College of Medicine, Gainesville, FL, USA
| | | |
Collapse
|
15
|
Associations of baseline depressed mood and happiness with subsequent well-being in cardiac patients. Soc Sci Med 2017; 174:209-212. [PMID: 28040301 DOI: 10.1016/j.socscimed.2016.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 11/22/2016] [Accepted: 12/08/2016] [Indexed: 11/23/2022]
Abstract
RATIONALE The relationship between depressive symptoms and adverse outcomes for patients with cardiac problems has been well established for several decades. However, less is known about other factors that may influence psychosocial outcomes for cardiac patients. OBJECTIVE To evaluate the association between baseline happiness and depressed mood on later psychosocial functioning among cardiac patients. METHOD Participants (N = 250) were patients who had received medical treatment at an academic medical center for a cardiac event. Participants completed questionnaires at two time points: Approximately 2 weeks after they had been discharged from the hospital (baseline) and again 12 weeks later. Participants completed validated measures of depressed mood, happiness, health distress, expectations about health, and quality of life. RESULTS Baseline depressed mood and happiness both significantly predicted health-related distress and depressive symptoms at follow up. Happiness ratings were associated with lower distress and depressed mood, whereas scores for depressive symptoms showed the opposite pattern. Happiness, but not depressed mood, was a significant predictor of more positive quality of life ratings. Conversely, only depressed mood was a significant predictor of less positive expectations about health. CONCLUSION The results of this study suggest that investigating positive baseline affect in addition to depressed mood provides additional useful information that may help explain why some patients have more negative outcomes following cardiac events.
Collapse
|
16
|
Im EO, Ko Y, Chee E, Chee W. Associations of Immigration Transition to Cardiovascular Symptoms Experienced in Menopausal Transition. FAMILY & COMMUNITY HEALTH 2017; 40:357-366. [PMID: 28820790 PMCID: PMC5785780 DOI: 10.1097/fch.0000000000000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to explore the associations of immigration transition to cardiovascular symptoms among 4 major racial/ethnic groups of 1054 midlife women in the United States. This was a secondary analysis of the data from 2 large national survey studies. The instruments included questions on background characteristics and immigration transition and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics including hierarchical multiple regressions. Immigrants reported fewer numbers (t = 5.268, P < .01) and lower severity scores (t = 5.493, P < .01) of cardiovascular symptoms compared with nonimmigrants. Self-reported racial/ethnic identify was a significant factor influencing cardiovascular symptoms (P < .01).
Collapse
Affiliation(s)
- Eun-Ok Im
- School of Nursing, Duke University, Durham, NC
| | - Young Ko
- College of Nursing, Gachon University, Inchon, South Korea
| | - Eunice Chee
- School of Nursing, Duke University, Durham, NC
| | | |
Collapse
|
17
|
Puig-Perez S, Hackett RA, Salvador A, Steptoe A. Optimism moderates psychophysiological responses to stress in older people with Type 2 diabetes. Psychophysiology 2016; 54:536-543. [PMID: 28000236 PMCID: PMC5396342 DOI: 10.1111/psyp.12806] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/14/2016] [Indexed: 12/21/2022]
Abstract
Optimism is thought to be beneficial for health, and these effects may be mediated through modifications in psychophysiological stress reactivity. Type 2 diabetes (T2D) is associated with reduced cardiovascular responses to stress and heightened cortisol over the day. This study assessed the relationships between optimism, stress responsivity, and daily cortisol output in people with T2D. A total of 140 participants with T2D were exposed to laboratory stress. Heart rate (HR), systolic (SBP), diastolic blood pressure (DBP), and cortisol were measured throughout the session. Cortisol output over the day was also assessed. Optimism and self‐reported health were measured using the revised Life Orientation Test and the Short Form Health Survey. Optimism was associated with heightened SBP and DBP stress reactivity (ps < .047) and lower daily cortisol output (p = .04). Optimism was not related to HR, cortisol stress responses, or the cortisol awakening response (ps > .180). Low optimism was related to poorer self‐reported physical and mental health (ps < .01). Optimism could have a protective role in modulating stress‐related autonomic and neuroendocrine dysregulation in people with T2D.
Collapse
Affiliation(s)
- S Puig-Perez
- Department of Psychobiology and IDOCAL, Laboratory of Social Cognitive Neuroscience, University of Valencia, Valencia, Spain
| | - R A Hackett
- Department of Epidemiology and Public Health, University College London, London, UK
| | - A Salvador
- Department of Psychobiology and IDOCAL, Laboratory of Social Cognitive Neuroscience, University of Valencia, Valencia, Spain
| | - A Steptoe
- Department of Epidemiology and Public Health, University College London, London, UK
| |
Collapse
|
18
|
Nikrahan GR, Suarez L, Asgari K, Beach SR, Celano CM, Kalantari M, Abedi MR, Etesampour A, Abbas R, Huffman JC. Positive Psychology Interventions for Patients With Heart Disease: A Preliminary Randomized Trial. PSYCHOSOMATICS 2016; 57:348-58. [PMID: 27137709 PMCID: PMC4902750 DOI: 10.1016/j.psym.2016.03.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 02/28/2016] [Accepted: 03/03/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Positive psychologic characteristics have been linked to superior cardiac outcomes. OBJECTIVE Accordingly, in this exploratory study, we assessed positive psychology interventions in patients who had recently undergone a procedure to treat cardiovascular disease. METHOD Participants were randomly assigned to receive 1 of 3 different 6-week face-to-face interventions or a wait-list control condition. We assessed intervention feasibility and compared changes in psychologic outcome measures postintervention (7wk) and at follow-up (15wk) between intervention and control participants. Across the interventions, 74% of assigned sessions were completed. RESULTS When comparing outcomes between interventions and control participants (N = 55 total), there were no between-group differences post-intervention, but at follow-up intervention participants had greater improvements in happiness (β = 14.43, 95% CI: 8.66-20.2, p < 0.001), depression (β = -3.87, 95% CI: -7.72 to 0.02, p = 0.049), and hope (β = 7.12, 95% CI: 1.25-13.00, p =0.017), with moderate-large effect sizes. Efficacy of the 3 interventions was similar. CONCLUSIONS Future studies are needed to identify an optimal positive psychology intervention for cardiac patients.
Collapse
Affiliation(s)
| | - Laura Suarez
- Department of Psychology, Islamic Azad University of Borujen, Borujen, Iran (GRN); Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Karim Asgari
- Department of Psychology, University of Isfahan, Isfahan, Iran
| | - Scott R Beach
- Department of Psychology, Islamic Azad University of Borujen, Borujen, Iran (GRN); Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Christopher M Celano
- Department of Psychology, Islamic Azad University of Borujen, Borujen, Iran (GRN); Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | | | | | - Ali Etesampour
- Department of Internal Medicine, Najafabad Islamic Azad University, Najafabad, Iran
| | - Rezaei Abbas
- Department of Immunology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jeff C Huffman
- Department of Psychology, Islamic Azad University of Borujen, Borujen, Iran (GRN); Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA.
| |
Collapse
|
19
|
Woods NF, Rillamas-Sun E, Cochrane BB, La Croix AZ, Seeman TE, Tindle HA, Zaslavsky O, Bird CE, Johnson KC, Manson JE, Ockene JK, Seguin RA, Wallace RB. Aging Well: Observations From the Women's Health Initiative Study. J Gerontol A Biol Sci Med Sci 2016; 71 Suppl 1:S3-S12. [PMID: 26858322 DOI: 10.1093/gerona/glv054] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND As the proportion of the population aged 80 and over accelerates, so does the value of understanding the processes of aging well. The purposes of this article are to: (a) review contemporary theoretical and conceptual perspectives on aging well, (b) describe indicators of aging well that reflect key concepts and perspectives as assessed in the Women's Health Initiative (WHI) and (c) characterize the status of aging among women aged 80 and older using data obtained from WHI participants at the WHI Extension 2 follow-up. METHODS Data from the Lifestyle Questionnaire, which was administered from 2011 to 2012 during the WHI Follow-up Study (Extension 2), were analyzed to provide a profile of the WHI cohort with respect to aging well. RESULTS Data revealed substantial diversity in the cohort with respect to the various measures of aging well. Although many reported physical functioning levels consistent with disability, most rated their health as good or better. Most reported moderately high levels of resilience, self-control, and self-mastery but lower levels of environmental mastery. Finally, the cohort reported high levels of optimal aging as reflected by their high levels of emotional well-being and moderately high levels of life satisfaction and social support, but more modest levels of personal growth and purpose in life. CONCLUSIONS The wide range of some dimensions of aging well suggest that further examination of predictors of positive coping and resilience in the face of aging-related disability could identify opportunities to support and facilitate aging well among U.S. women.
Collapse
Affiliation(s)
| | | | - Barbara B Cochrane
- Department of Family and Child Nursing, University of Washington, Seattle. The de Tornyay Endowed Professorship in Healthy Aging, de Tornyay Center for Healthy Aging, University of Washington School of Nursing, Seattle
| | - Andrea Z La Croix
- Department of Epidemiology, Famiy and Preventive Medicine, University of California at San Diego, La Jolla
| | - Teresa E Seeman
- Department of Medicine and Epidemiology, David Geffen School of Medicine at UCLA
| | - Hilary A Tindle
- Departments of Medicine and Epidemiology, and Clinical and Translational Science, University of Pittsburgh, Pennsylvania
| | | | | | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Maryland
| | - Judith K Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester
| | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | | |
Collapse
|
20
|
Jabson JM, Bowen D, Weinberg J, Kroenke C, Luo J, Messina C, Shumaker S, Tindle HA. Psychosocial Clusters and their Associations with Well-Being and Health: An Empirical Strategy for Identifying Psychosocial Predictors Most Relevant to Racially/Ethnically Diverse Women's Health. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2016; 9:31-40. [PMID: 27279761 PMCID: PMC4896535 DOI: 10.4137/cmwh.s34692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/08/2016] [Accepted: 03/10/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Strategies for identifying the most relevant psychosocial predictors in studies of racial/ethnic minority women’s health are limited because they largely exclude cultural influences and they assume that psychosocial predictors are independent. This paper proposes and tests an empirical solution. METHODS Hierarchical cluster analysis, conducted with data from 140,652 Women’s Health Initiative participants, identified clusters among individual psychosocial predictors. Multivariable analyses tested associations between clusters and health outcomes. RESULTS A Social Cluster and a Stress Cluster were identified. The Social Cluster was positively associated with well-being and inversely associated with chronic disease index, and the Stress Cluster was inversely associated with well-being and positively associated with chronic disease index. As hypothesized, the magnitude of association between clusters and outcomes differed by race/ethnicity. CONCLUSIONS By identifying psychosocial clusters and their associations with health, we have taken an important step toward understanding how individual psychosocial predictors interrelate and how empirically formed Stress and Social clusters relate to health outcomes. This study has also demonstrated important insight about differences in associations between these psychosocial clusters and health among racial/ethnic minorities. These differences could signal the best pathways for intervention modification and tailoring.
Collapse
Affiliation(s)
- Jennifer M Jabson
- Department of Public Health, University of Tennessee, Knoxville, TN, USA
| | - Deborah Bowen
- Department of Bioethics and Humanities, University of Washington, Seattle, WA, USA
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Candyce Kroenke
- Kaiser Permanente Division of Research, Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, USA
| | - Catherine Messina
- Community and Behavioral Health, Stony Brook Medicine, Stony Brook, NY, USA
| | - Sally Shumaker
- Social Sciences and Health Polic, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| |
Collapse
|
21
|
Avvenuti G, Baiardini I, Giardini A. Optimism's Explicative Role for Chronic Diseases. Front Psychol 2016; 7:295. [PMID: 26973582 PMCID: PMC4773598 DOI: 10.3389/fpsyg.2016.00295] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/16/2016] [Indexed: 11/13/2022] Open
Abstract
The increasing interest about dispositional optimism's role in health status and its positive modulating effect on health outcomes has led to a remarkable scientific production in the last decade. To date lot is known for which diseases optimism is relevant, instead much less is known about how optimism interacts with other factors, both biological and psychological, in determining health status. The aim of this mini review is to explore the literature derived from clinical and experimental research assessing the associations between dispositional optimism and health status. Dispositional optimism can be considered as facet of personality that is cognitive in nature which holds the global expectation that the future will be plenty of good events. Optimists view desired goals as obtainable, so they often confront adversities in active manners resulting in perseverance and increased goal attainment. Only studies that explicitly included optimism and health outcomes, as measurable variables, and that reported a clear association between them have been reviewed. Cancer, cardiovascular disease, respiratory failure, and aging with multimorbidity were considered. Among the possible explicative hypotheses, two seem to best describe results: optimism may have a direct effect on the neuroendocrine system and on immune responses, and it may have an indirect effect on health outcomes by promoting protective health behaviors, adaptive coping strategies and enhancing positive mood. The research on optimism and health status has already shed light on important mechanisms regarding chronic diseases' management, however, further studies are needed to deepen the knowledge.
Collapse
Affiliation(s)
- Giulia Avvenuti
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico Montescano, Italy
| | - Ilaria Baiardini
- Allergy and Respiratory Diseases Clinic, Department of Internal Medicine, University of Genoa - IRCCS AOU San Martino-IST Genova, Italy
| | - Anna Giardini
- Psychology Unit, Scientific Institute of Montescano, Salvatore Maugeri Foundation, Istituto di Ricovero e Cura a Carattere Scientifico Montescano, Italy
| |
Collapse
|
22
|
Goveas JS, Rapp SR, Hogan PE, Driscoll I, Tindle HA, Smith JC, Kesler SR, Zaslavsky O, Rossom RC, Ockene JK, Yaffe K, Manson JE, Resnick SM, Espeland MA. Predictors of Optimal Cognitive Aging in 80+ Women: The Women's Health Initiative Memory Study. J Gerontol A Biol Sci Med Sci 2016; 71 Suppl 1:S62-71. [PMID: 26858326 PMCID: PMC4759985 DOI: 10.1093/gerona/glv055] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 04/02/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Independent predictors of preserved cognitive functioning and factors associated with maintaining high preserved cognitive function in women ≥ 80 years remain elusive. METHODS Two thousand two hundred twenty-eight women with a mean age of 85 years who participated in the Women's Health Initiative Memory Study were classified as cognitively normal (n = 1,905, 85.5%), mild cognitive impairment (n = 88, 3.9%), dementia (n = 121, 5.4%) or other cognitive impairment (n = 114, n = 5.1%) by central adjudication. Global cognitive functioning was assessed using telephone interview for cognitive status-modified in those women who did not meet cognitive impairment criteria. Differences between women grouped by cognitive status with respect to each potential risk factor were assessed using chi-squared tests and t-tests. Backward stepwise logistic regression was used to select factors that were independently associated with cognitive status. RESULTS Factors associated with preserved cognitive functioning were younger age, higher education, and family incomes, being non-Hispanic white, better emotional wellbeing, fewer depressive symptoms, more insomnia complaints, being free of diabetes, and not carrying the apolipoprotein E-epsilon 4 allele. Cognitively normal women who demonstrated sustained high preserved cognition were younger, more educated, and endorsed better self-reported general health, emotional wellbeing, and higher physical functioning. CONCLUSIONS Addressing sociodemographic disparities such as income inequality, and targeting interventions to improve depressive symptoms and vascular risk factors, including diabetes, may play an important role in preserving cognition among women who survive to 80 years of age. Person-centered approaches that combine interventions to improve physical, cognitive, and psychosocial functioning may promote maintenance of high preserved cognitive health in the oldest-old.
Collapse
Affiliation(s)
- Joseph S Goveas
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee.
| | | | - Patricia E Hogan
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ira Driscoll
- Department of Psychology, University of Wisconsin at Milwaukee
| | - Hilary A Tindle
- Division of Internal Medicine, University of Pittsburgh, Pennsylvania
| | - J Carson Smith
- Department of Kinesiology, University of Maryland, College Park
| | - Shelli R Kesler
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Palo Alto, California
| | - Oleg Zaslavsky
- Department of Nursing, Faculty of Health Science and Social Welfare, University of Haifa, Israel
| | - Rebecca C Rossom
- HealthPartners Insitute for Education and Research, Minneapolis, Minnesota
| | - Judith K Ockene
- Department of Medicine, University of Massachusetts Medical School, Worcester
| | - Kristine Yaffe
- Department of Psychiatry, Neurology and Epidemiology, University of California, San Francisco
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, Maryland
| | - Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| |
Collapse
|
23
|
Bersani FS, Wolkowitz OM, Lindqvist D, Yehuda R, Flory J, Bierer LM, Makotine I, Abu-Amara D, Coy M, Reus VI, Epel ES, Marmar C, Mellon SH. Global arginine bioavailability, a marker of nitric oxide synthetic capacity, is decreased in PTSD and correlated with symptom severity and markers of inflammation. Brain Behav Immun 2016; 52:153-160. [PMID: 26515034 DOI: 10.1016/j.bbi.2015.10.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 10/25/2015] [Accepted: 10/26/2015] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Psychiatric, physical and biological aspects of posttraumatic stress disorder (PTSD) may be associated with dysfunctions in several cellular processes including nitric oxide (NO) production. NO is synthesized from arginine in a reaction carried out by NO synthase (NOS) enzymes. The recently introduced "global arginine bioavailability ratio" (GABR; ratio of arginine to [ornithine+citrulline]) has been proposed as a reliable approximation of NO synthetic capacity in vivo. The objectives of the present study were to test the hypotheses that (i) subjects with combat-related PTSD have lower GABR scores than combat controls, (ii) GABR score is inversely associated with the severity of psychopathological measures, (iii) GABR score is inversely associated with markers of inflammation. METHODS Metabolic profiling for plasma samples (i.e. arginine, citrulline and ornithine) and inflammation markers (interleukin [IL]-6, IL-1β, tumor necrosis factor [TNF]-α, interferon [IFN]-γ and C-reactive protein [CRP]) were assessed in 56 combat-exposed males with PTSD and 65 combat-exposed males without PTSD. We assessed severity of PTSD (Clinician Administered PTSD Scale [CAPS]) and depression (Beck Depression Inventory-II [BDI-II]) as well as history of early life trauma (Early Trauma Inventory [ETI]) and affectivity (Positive and Negative Affect Schedule [PANAS]). RESULTS The GABR value was (i) significantly lower in PTSD subjects compared to controls (p=0.001), (ii) significantly inversely correlated with markers of inflammation including IL6 (p=0.04) and TNFα (p=0.02), and (iii) significantly inversely correlated with CAPS current (p=0.001) and lifetime (p<0.001) subscales, ETI (p=0.045) and PANAS negative (p=0.006). Adding antidepressant use or MDD diagnosis as covariates led to similar results. Adding age and BMI as covariates also led to similar results, with the exception of IL6 and ETI losing their significant association with GABR. DISCUSSION This study provides the first evidence that global arginine bioavailability, a marker of NO synthetic capacity in vivo, is lower in veterans with PTSD and is negatively associated with some markers of inflammation as well as with measures of PTSD symptom severity, negative affectivity and childhood adverse experiences. These findings add to the accumulating evidence that specific cellular dysfunction may be associated with the symptomatology of PTSD and may help to explain the higher burden of cardio-metabolic disturbances seen in this disorder.
Collapse
Affiliation(s)
- Francesco Saverio Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States.
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Linda M Bierer
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Iouri Makotine
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; James J. Peters Veterans Affairs Medical Center, New York, NY, United States
| | - Duna Abu-Amara
- Department of Psychiatry, New York University, United States; Department of Psychiatry, Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, United States
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | - Elissa S Epel
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States; Center for Health and Community, University of California San Francisco, San Francisco, CA, United States
| | - Charles Marmar
- Department of Psychiatry, New York University, United States; Department of Psychiatry, Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, United States
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, United States
| |
Collapse
|
24
|
Optimism and pessimism are related to different components of the stress response in healthy older people. Int J Psychophysiol 2015; 98:213-21. [DOI: 10.1016/j.ijpsycho.2015.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 11/30/2022]
|
25
|
DuBois CM, Lopez OV, Beale EE, Healy BC, Boehm JK, Huffman JC. Relationships between positive psychological constructs and health outcomes in patients with cardiovascular disease: A systematic review. Int J Cardiol 2015; 195:265-80. [PMID: 26048390 DOI: 10.1016/j.ijcard.2015.05.121] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 02/06/2023]
Abstract
Depression and anxiety are well-known to be associated with adverse health outcomes in cardiac patients. However, there has been less work synthesizing the effects of positive psychological constructs (e.g., optimism) on health-related outcomes in cardiac patients. We completed a systematic review of prospective observational studies using established guidelines. A search of PubMed and PsycINFO databases from inception to January 2014 was used to identify articles. To be eligible, studies were required to assess effects of a positive psychological construct on subsequent health-related outcomes (including mortality, rehospitalizations, self-reported health status) in patients with established heart disease. Exploratory random effects' meta-analyses were performed on the subset of studies examining mortality or rehospitalizations. Seventy-seven analyses from 30 eligible studies (N=14,624) were identified. Among studies with 100 or more participants, 65.0% of all analyses and 64.7% of analyses adjusting for one or more covariates reported a significant (p<.05) association between positive psychological constructs and subsequent health outcomes. An exploratory meta-analysis of 11 studies showed that positive constructs were associated with reduced rates of rehospitalization or mortality in unadjusted (odds ratio=.87; 95% confidence interval [.83, .92]; p<.001) and adjusted analyses (odds ratio=.89; 95% confidence interval [.84, .91]; p<.001); there was little suggestion of publication bias. Among cardiac patients, positive psychological constructs appear to be prospectively associated with health outcomes in most but not all studies. Additional work is needed to identify which constructs are most important to cardiac health, and whether interventions can cultivate positive attributes and improve clinical outcomes.
Collapse
Affiliation(s)
- Christina M DuBois
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Oriana Vesga Lopez
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Eleanor E Beale
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Brian C Healy
- Harvard Medical School, Boston, MA, United States; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA, United States
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States; Department of Neurology, Massachusetts General Hospital, Boston, MA, United States.
| |
Collapse
|
26
|
Im EO, Ham OK, Chee E, Chee W. Racial/Ethnic Differences in Cardiovascular Symptoms in Four Major Racial/Ethnic Groups of Midlife Women: A Secondary Analysis. Women Health 2015; 55:525-47. [PMID: 25826460 DOI: 10.1080/03630242.2015.1022813] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Ethnic minority midlife women frequently do not recognize cardiovascular symptoms that they experience during the menopausal transition. Racial/ethnic differences in cardiovascular symptoms are postulated as a plausible reason for their lack of knowledge and recognition of the symptoms. The purpose of this study was to explore racial/ethnic differences in midlife women's cardiovascular symptoms and to determine the factors related to these symptoms in each racial/ethnic group. This was a secondary analysis of the data from a larger study among 466 participants, collected from 2006 to 2011. The instruments included questions on background characteristics, health and menopausal status, and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics, including Poisson regression and logistic regression analyses. Significant racial/ethnic differences were observed in the total numbers and total severity scores of cardiovascular symptoms (p < .01). Non-Hispanic Asians had significantly lower total numbers and total severity scores compared to other racial/ethnic groups (p < .05). The demographic and health factors associated with cardiovascular symptoms were somewhat different in each racial/ethnic group. Further studies are needed about possible reasons for the racial/ethnic differences and the factors associated with cardiovascular symptoms in each racial/ethnic group.
Collapse
Affiliation(s)
- Eun-Ok Im
- a School of Nursing , University of Pennsylvania , Philadelphia , Pennsylvania , USA
| | | | | | | |
Collapse
|
27
|
Pavlov SV, Reva NV, Loktev KV, Korenyok VV, Aftanas LI. Impact of long-term meditation practice on cardiovascular reactivity during perception and reappraisal of affective images. Int J Psychophysiol 2015; 95:363-71. [PMID: 25583571 DOI: 10.1016/j.ijpsycho.2015.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 11/05/2014] [Accepted: 01/05/2015] [Indexed: 12/19/2022]
Abstract
Meditation has been found to be an efficient strategy for coping with stress in healthy individuals and in patients with psychosomatic disorders. The main objective of the present study was to investigate the psychophysiological mechanisms of beneficial effects of meditation on cardiovascular reactivity. We examined effects of long-term Sahaja Yoga meditation on cardiovascular reactivity during affective image processing under "unregulated" and "emotion regulation" conditions. Twenty two experienced meditators and 20 control subjects participated in the study. Under "unregulated" conditions participants were shown neutral and affective images and were asked to attend to them. Under "emotion regulation" conditions they down-regulated negative affect through reappraisal of negative images or up-regulated positive affect through reappraisal of positive images. Under "unregulated" conditions while anticipating upcoming images meditators vs. controls did not show larger pre-stimulus total peripheral resistance and greater cardiac output for negative images in comparison with neutral and positive ones. Control subjects showed TPR decrease for negative images only when they consciously intended to reappraise them (i.e. in the "emotion regulation" condition). Both meditators and controls showed comparable cardiovascular reactivity during perception of positive stimuli, whereas up-regulating of positive affect was associated with more pronounced cardiac activation in meditators. The findings provide some insight into understanding the beneficial influence of meditation on top-down control of emotion and cardiovascular reactivity.
Collapse
Affiliation(s)
- Sergei V Pavlov
- Laboratory of Psychophysiology of the Federal State Budgetary Institution "Scientific Research Institute of Physiology and Basic Medicine" under the Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation, Timakova St. 4, 630117 Novosibirsk, Russia.
| | - Natalia V Reva
- Laboratory of Psychophysiology of the Federal State Budgetary Institution "Scientific Research Institute of Physiology and Basic Medicine" under the Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation, Timakova St. 4, 630117 Novosibirsk, Russia.
| | - Konstantin V Loktev
- Laboratory of Psychophysiology of the Federal State Budgetary Institution "Scientific Research Institute of Physiology and Basic Medicine" under the Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation, Timakova St. 4, 630117 Novosibirsk, Russia.
| | - Vladimir V Korenyok
- Laboratory of Psychophysiology of the Federal State Budgetary Institution "Scientific Research Institute of Physiology and Basic Medicine" under the Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation, Timakova St. 4, 630117 Novosibirsk, Russia.
| | - Lyubomir I Aftanas
- Laboratory of Psychophysiology of the Federal State Budgetary Institution "Scientific Research Institute of Physiology and Basic Medicine" under the Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation, Timakova St. 4, 630117 Novosibirsk, Russia.
| |
Collapse
|
28
|
Huffman JC, Moore SV, DuBois CM, Mastromauro CA, Suarez L, Park ER. An exploratory mixed methods analysis of adherence predictors following acute coronary syndrome. PSYCHOL HEALTH MED 2014; 20:541-50. [PMID: 25495864 DOI: 10.1080/13548506.2014.989531] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Adherence to cardiac health behaviors is a critical predictor of prognosis in the months following an acute coronary syndrome (ACS). However, there has been minimal concomitant study of multiple nonadherence risk factors, as assessed via record review, structured assessments, and qualitative interviews, among hospitalized ACS patients. Accordingly, we completed an exploratory mixed methods study with 22 individuals who were admitted for ACS and had suboptimal pre-ACS adherence to physical activity, heart-healthy diet, and/or medications, defined by a Medical Outcomes Study Specific Adherence Scale (MOS SAS) score <15/18. During hospitalization, participants underwent quantitative assessments of sociodemographic, medical, and psychological variables, followed by in-depth semi-structured interviews to explore intentions, plans, and perceived barriers related to post-discharge health behavior changes. The MOS SAS was readministered at 3 months and participants were designated as persistently nonadherent (MOS SAS <15; n = 9) or newly adherent (n = 13). Interviews were transcribed and coded by trained raters via content analysis, and quantitative variables were compared between groups using chi-square analysis and independent-samples t-tests. On our primary qualitative analysis, we found that participants with vaguely described intentions/plans regarding health behavior change, and those who focused on barriers to change that were perceived as static, were more likely to be persistently nonadherent. On exploratory quantitative analyses, greater medical burden, diabetes, depressive symptoms, and low optimism/positive affect at baseline were associated with subsequent post-ACS nonadherence (all p < .05). In conclusion, this appears to be the first study to prospectively examine all of these constructs in hospitalized ACS patients, and we found that specific factors were associated with nonadherence to key health behaviors 3 months later. Therefore it may be possible to predict future nonadherence in ACS patients, even during hospitalization, and specific interventions during admission may be indicated to prevent adverse outcomes among patients at highest risk for post-ACS nonadherence.
Collapse
Affiliation(s)
- Jeff C Huffman
- a Department of Psychiatry , Massachusetts General Hospital , 55 Fruit Street/Blake 11, Boston , MA , USA
| | | | | | | | | | | |
Collapse
|
29
|
Nekouei ZK, Yousefy A, Doost HTN, Manshaee G, Sadeghei M. Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2014; 19:90-8. [PMID: 24778660 PMCID: PMC3999613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/08/2013] [Accepted: 12/01/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. MATERIALS AND METHODS The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21), life orientation (LOT-10), general self-efficacy (GSE-10), depression, anxiety and stress (DASS-21), perceived stress (PSS-14), multidimensional social support (MSPSS-12), alexithymia (TAS-20), spiritual intelligence (SQ-23) and quality of life (WHOQOL-26). RESULTS The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and -0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25), the Comparative Fit Index (CFI = 0.93), the Parsimony Comparative Fit Index (PCFI = 0.68), the Root Mean Square Error of Approximation (RMSEA = 0.07) and details of the model (significance of the relationships) it has been confirmed that the psychocardiological structural model of the study is the good fitting model. CONCLUSION This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have emphasized the necessity of noticing the psychological factors in primary prevention by preventive programs and in secondary prevention by rehabilitation centers to improve the quality of life of the people with heart diseases.
Collapse
Affiliation(s)
- Zohreh Khayyam Nekouei
- Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | - Alireza Yousefy
- Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Taher Neshat Doost
- Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | - Gholamreza Manshaee
- Department of Psychology, Isfahan Sciences and Research Branch, Islamic Azad University, Isfahan, Iran
| | - Masoumeh Sadeghei
- Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan, Iran
| |
Collapse
|
30
|
Pavlov SV, Reva NV, Loktev KV, Tumyalis AV, Korenyok VV, Aftanas LI. The temporal dynamics of cognitive reappraisal: cardiovascular consequences of downregulation of negative emotion and upregulation of positive emotion. Psychophysiology 2013; 51:178-86. [PMID: 24131042 DOI: 10.1111/psyp.12159] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 09/07/2013] [Indexed: 11/28/2022]
Abstract
This study examines the effects of cognitive reappraisal on the cardiovascular response to affective stimuli. Participants (N = 53) were shown affective images and were asked either to attend to the images, or to downregulate negative affect through reappraisal of negative images or upregulate positive affect through reappraisal of positive images while continuous measures of cardiovascular activity were recorded. Reappraisal of negative images was associated with lower total peripheral resistance and larger cardiac output in the prestimulus period, whereas reappraisal of positive images was associated with less pronounced decreases of heart rate, cardiac output, and mean blood pressure in the viewing period as compared to unregulated conditions. The results indicate that cognitive reappraisal engenders adaptive hemodynamic profiles both during anticipation and during viewing of affective images depending on their valence and the regulatory goal.
Collapse
Affiliation(s)
- Sergei V Pavlov
- Laboratory of Psychophysiology of the Federal State Budgetary Institution "Scientific Research Institute of Physiology and Basic Medicine" under the Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russian Federation
| | | | | | | | | | | |
Collapse
|
31
|
Silarova B, van Dijk JP, Nagyova I, Rosenberger J, Reijneveld SA. Differences in health-related quality of life between Roma and non-Roma coronary heart disease patients: the role of hostility. Int J Public Health 2013; 59:271-7. [PMID: 23842582 DOI: 10.1007/s00038-013-0490-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 06/02/2013] [Accepted: 07/01/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess differences in health-related quality of life (HRQoL) between Roma and non-Roma coronary heart disease (CHD) patients, and whether differences in hostility contribute to this association. METHODS We examined 570 CHD patients (mean age 57.8, 28.1 % female) scheduled for coronary angiography, 88 (15.4 %) of whom were Roma. Hostility was measured using the 27-item Cook-Medley Scale and HRQoL using the Short-Form Health Survey 36, from which the mental and physical component summary (MCS, PCS) were calculated. The relationship between ethnicity, hostility and HRQoL was examined using regression analyses. RESULTS Roma ethnicity was associated with poorer MCS (B = -3.44; [95 % CI = -6.76; -0.13] and poorer PCS (B = -4.16; [95 % CI = -7.55; -0.78]) when controlled for age, gender and socioeconomic status. Adding hostility to the model weakened the strength of the association between Roma ethnicity and MCS (B = -1.87; [95 % CI = -5.08; 1.35]) but not between Roma ethnicity and PCS (B = -4.07; [95 % CI = -7.50; -0.64]). CONCLUSIONS Roma ethnicity is associated with poorer MCS and PCS. Hostility may mediate the association between Roma ethnicity and MCS. The poorer HRQoL of Roma CHD patients requires attention in both care and research, with special attention on the role of hostility.
Collapse
Affiliation(s)
- Barbora Silarova
- Faculty of Medicine, Graduate School Kosice Institute for Society and Health, Safarik University, Trieda SNP 1, 040 11, Kosice, Slovak Republic,
| | | | | | | | | |
Collapse
|
32
|
Improving the Cardiovascular Health of the Population through Standard and Novel Strategies. CURRENT CARDIOVASCULAR RISK REPORTS 2012. [DOI: 10.1007/s12170-012-0276-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
33
|
Foraker RE, Olivo-Marston SE, Allen NB. Lifestyle and Primordial Prevention of Cardiovascular Disease: Challenges and Opportunities. CURRENT CARDIOVASCULAR RISK REPORTS 2012. [DOI: 10.1007/s12170-012-0265-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
34
|
Harmsen CG, Støvring H, Jarbøl DE, Nexøe J, Gyrd-Hansen D, Nielsen JB, Edwards A, Kristiansen IS. Medication effectiveness may not be the major reason for accepting cardiovascular preventive medication: a population-based survey. BMC Med Inform Decis Mak 2012; 12:89. [PMID: 22873796 PMCID: PMC3465182 DOI: 10.1186/1472-6947-12-89] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 08/02/2012] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Shared decision-making and patients' choice of interventions are areas of increasing importance, not least seen in the light of the fact that chronic conditions are increasing, interventions considered important for public health, and still non-acceptance of especially risk-reducing treatments of cardiovascular diseases (CVD) is prevalent. A better understanding of patients' medication-taking behavior is needed and may be reached by studying the reasons why people accept or decline medication recommendations. The aim of this paper was to identify factors that may influence people's decisions and reasoning for accepting or declining a cardiovascular preventive medication offer. METHODS From a random sample of 4,000 people aged 40-59 years in a Danish population, 1,169 participants were asked to imagine being at increased risk of cardiovascular disease and being offered a preventive medication. After receiving 'complete' information about effectiveness of the medication they were asked whether they would accept medication. Finally, they were asked about reasons for the decision. RESULTS A total of 725 (67%) of 1,082 participants accepted the medication offer. Even quite large effects of medication (up to 8 percentage points absolute risk reduction) had a smaller impact on acceptance to medication than personal experience with cardiovascular disease. Furthermore, increasing age of the participant and living with a partner were significantly associated with acceptance. Some 45% of the respondents accepting justified their choice as being for health reasons, and they were more likely to be women, live alone, have higher income and higher education levels. Among those who did not accept the medication offer, 56% indicated that they would rather prefer to change lifestyle. CONCLUSIONS Medication effectiveness seems to have a moderate influence on people's decisions to accept preventive medication, while factors such as personal experience with cardiovascular disease may have an equally strong or stronger influence, indicating that practitioners could do well to carefully identify the reasons for their patients' treatment decisions.
Collapse
Affiliation(s)
| | - Henrik Støvring
- Department of Public Health, Biostatistics, Aarhus University, Aarhus, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Jørgen Nexøe
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Dorte Gyrd-Hansen
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Bo Nielsen
- Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Adrian Edwards
- Department of Primary Care & Public Health, School of Medicine, Cardiff University, Wales, UK
| | - Ivar Sønbø Kristiansen
- Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| |
Collapse
|
35
|
DuBois CM, Beach SR, Kashdan TB, Nyer MB, Park ER, Celano CM, Huffman JC. Positive Psychological Attributes and Cardiac Outcomes: Associations, Mechanisms, and Interventions. PSYCHOSOMATICS 2012; 53:303-18. [DOI: 10.1016/j.psym.2012.04.004] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/30/2012] [Accepted: 04/02/2012] [Indexed: 11/25/2022]
|
36
|
Kashani M, Eliasson A, Vernalis M. Perceived stress correlates with disturbed sleep: a link connecting stress and cardiovascular disease. Stress 2012; 15:45-51. [PMID: 21682656 DOI: 10.3109/10253890.2011.578266] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The association between stress and cardiovascular disease (CVD) risk is becoming established. A mechanistic link clarifying the intermediate steps between the experience of stress and the development of CVD would support this association. We sought to examine the role of perceived stress as a factor associated with disturbed sleep with the goal of providing an explanation for the stress-CVD connection. We performed a cross-sectional analysis of data recorded by subjects at entry to our CVD prevention program. Data collection included questionnaire surveys, anthropometrics, and a CVD-relevant laboratory panel. Of 350 consecutively enrolled subjects (mean age 54.4 ± 12.4 [SD] years, 138 men, 39%), 165 (47%) scored above the mean for stress measures. These high-stress subjects displayed an increased cardiovascular risk profile including elevated body mass index (mean ± SD 31.1 ± 5.9 vs. 29.0 ± 5.9, r(s) = 0.175), increased waist circumference (102 ± 17 cm vs. 98 ± 14, r(s) = 0.135), and elevated high-sensitivity serum C-reactive protein (0.384 mg/dl vs. 0.356, r(s) = 0.109). High-stress subjects also demonstrated greater daytime sleepiness (Epworth Sleepiness Scale: 10.4 ± 5.0 vs. 7.8 ± 4.8, r(s) < 0.316), greater fatigue (fatigue scale: 5.4 ± 2.2 vs. 3.4 ± 2.4, r(s) = 0.484), poorer sleep quality (Pittsburgh Sleep Quality Index: 8.5 ± 4.4 vs. 5.9 ± 4.0, r(s) = 0.416), and shorter sleep duration (20 min less/24 h, r(s) = negative 0.177) with a higher risk for sleep apnea (60% at high risk vs. 40%, p = 0.003) than low-stress subjects. High stress was associated with significant disturbances in sleep duration and sleep quality. Stress levels also correlated with daytime consequences of disturbed sleep. The stress-sleep connection may be an important mechanistic mediator of the association between stress and CVD.
Collapse
Affiliation(s)
- Mariam Kashani
- Integrative Cardiac Health Project, Walter Reed Army Medical Center, Washington, DC 20012-0608, USA
| | | | | |
Collapse
|
37
|
Huffman JC, Mastromauro CA, Boehm JK, Seabrook R, Fricchione GL, Denninger JW, Lyubomirsky S. Development of a positive psychology intervention for patients with acute cardiovascular disease. Heart Int 2011; 6:e14. [PMID: 23825741 PMCID: PMC3699107 DOI: 10.4081/hi.2011.e14] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Accepted: 09/26/2011] [Indexed: 01/21/2023] Open
Abstract
The management of depression and other negative psychological states in cardiac patients has been
a focus of multiple treatment trials, though such trials have not led to substantial improvements in
cardiac outcomes. In contrast, there has been minimal focus on interventions to increase positive
psychological states in cardiac patients, despite the fact that optimism and other positive states
have been associated with superior cardiovascular outcomes. Our objective was to develop an 8-week,
phone-based positive psychology intervention for patients hospitalized with acute cardiac disease
(acute coronary syndrome or decompensated heart failure). Such an intervention would consist of
positive psychology exercises adapted for this specific population, and it would need to be feasible
for practitioners and patients in real-world settings. By adapting exercises that were previously
validated in healthy individuals, we were able to generate a positive psychology telemedicine
intervention for cardiac patients that focused on optimism, kindness, and gratitude. In addition, we
successfully created a companion treatment manual for subjects to enhance the educational aspects of
the intervention and facilitate completion of exercises. Finally, we successfully performed a small
pilot trial of this intervention, and found that the positive psychology intervention appeared to be
feasible and well-accepted in a cohort of patients with acute cardiac illness. Future studies should
further develop this promising intervention and examine its impact on psychological and medical
outcomes in this vulnerable population of cardiac patients.
Collapse
Affiliation(s)
- Jeff C Huffman
- Harvard Medical School, Boston, MA; ; Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | | | | | | | | | | | | |
Collapse
|
38
|
Current world literature. Curr Opin Cardiol 2011; 26:457-61. [PMID: 21832895 DOI: 10.1097/hco.0b013e32834b1910] [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: 11/26/2022]
|
39
|
Tilvis RS, Laitala V, Routasalo P, Strandberg TE, Pitkala KH. Positive life orientation predicts good survival prognosis in old age. Arch Gerontol Geriatr 2011; 55:133-7. [PMID: 21764146 DOI: 10.1016/j.archger.2011.06.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 06/22/2011] [Accepted: 06/23/2011] [Indexed: 10/18/2022]
Abstract
The purpose of this study is to investigate the value of life orientation as a screening tool and survival indicator in old age. A postal questionnaire answered by 2490 random older people (>75 years) included six questions concerning satisfaction with life, feeling needed, plans for future, zest for life, lack of feelings of depression and loneliness. The vital status was followed for 57 months. All-cause mortality rate was 19.1% and 30.3% among elderly with (22%) and without (78%) positive life orientation, respectively (p<0.001). The difference in mortality increased over time. After controlling for age, gender, and subjective health, the protective value of positive life orientation remained significant (hazard ratio, HR=0.78, 95%CI=0.63-0.98, p<0.03). Feeling needed was the strongest independent predictor (HR=0.72, p<0.001). A six-question life orientation identifies old people at risk. Positive life orientation predicts good survival prognosis independently of subjective health.
Collapse
Affiliation(s)
- Reijo S Tilvis
- Clinics of General Internal Medicine and Geriatrics, Helsinki University Hospital, Box 340, 00290 Helsinki, Finland.
| | | | | | | | | |
Collapse
|