1
|
Muhie NS, Tegegne AS. Determinants of hemoglobin level and time to default from Highly Active Antiretroviral Therapy (HAART) for adult clients living with HIV under treatment; a retrospective cohort study design. Sci Rep 2024; 14:14929. [PMID: 38942753 PMCID: PMC11213870 DOI: 10.1038/s41598-024-62952-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 05/23/2024] [Indexed: 06/30/2024] Open
Abstract
HIV/AIDS is one of the most devastating infectious diseases affecting humankind all over the world and its impact goes beyond public health problems. This study was conducted to investigate the joint predictors of hemoglobin level and time to default from treatment for adult clients living with HIV/AIDS under HAART at the University of Gondar Comprehensive and Specialized Hospital, North-west Ethiopia. The study was conducted using a retrospective cohort design from the medical records of 403 randomly selected adult clients living with HIV whose follow-ups were from September 2015 to March 2022. Hemoglobin level was projected using Sahli's acid-hematin method. Hence, the hemoglobin tube was filled with N/10 hydrochloric acid up to 2 g % marking and the graduated tube was placed in Sahli's hemoglobin meter. The blood samples were collected using the finger-pick method, considering 22 G disposable needles. The health staff did this. From a total of 403 adult patients living with HIV/AIDS included in the current study, about 44.2% defaulted from therapy. The overall mean and median estimated survival time of adult clients under study were 44.3 and 42 months respectively. The patient's lymphocyte count (AHR = 0.7498, 95% CI: (0.7411: 0.7587), p-value < 0.01), The weight of adult patients living with HIV/AIDS (AHR = 0.9741, 95% CI: (0.9736: 0.9747), p-value = 0.012), sex of adult clients (AHR = 0.6019, 95% CI: (0.5979, 0.6059), p-value < 0.01), WHO stages III compared to Stage I (AHR = 1.4073, 95% CI: (1.3262, 1.5078), p-value < 0.01), poor adherence level (AHR = 0.2796, 95% CI: (0.2082, 0.3705) and p-value < 0.01), bedridden patients (AHR = 1.5346, 95% CI: (1.4199, 1.6495), p-value = 0.008), and opportunistic infections (AHR = 0.2237, 95% CI: (0.0248, 0.4740), p-value = 0.004) had significant effect on both hemoglobin level and time to default from treatment. Similarly, other co-morbidity conditions, disclosure status of the HIV disease, and tobacco and alcohol addiction had a significant effect on the variables of interest. The estimate of the association parameter in the slope value of Hgb level and time default was negative, indicating that the Hgb level increased as the hazard of defaulting from treatment decreased. A patient with abnormal BMI like underweight, overweight, or obese was negatively associated with the risk of anemia (lower hemoglobin level). As a recommendation, more attention should be given to those patients with abnormal BMI, patients with other co-morbidity conditions, patients with opportunistic infections, and low lymphocytes, and bedridden and ambulatory patients. Health-related education should be given to adult clients living with HIV/AIDS to be good adherents for medical treatment.
Collapse
Affiliation(s)
- Nurye Seid Muhie
- Department of Statistics, Mekidela Amba University, Tulu Awulia, Ethiopia
| | | |
Collapse
|
2
|
Tan SC, Gamaldo AA, Evans MK, Zonderman AB. Examining the Impact of Race and Poverty on the Relationship Between Purpose in Life and Functional Health: Insights from the HANDLS Study. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02021-0. [PMID: 38771450 DOI: 10.1007/s40615-024-02021-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 04/09/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
INTRODUCTION While research has shown a positive association between a higher sense of purpose in life and functional health, there is a gap in understanding its benefits for racially minoritized and low SES individuals. This study aimed to investigate the correlation between purpose in life and physical functional health in a diverse sample, hypothesizing that purpose in life would be negatively associated with functional difficulties, with potentially stronger associations in White and high SES groups. METHODS Data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were utilized (166 participants, mean age 59.44 [SD = 8.28], 59.6% females, 65.06% Black participants, 40.36% below poverty). Purpose in life was measured by Ryff's Psychological Well-being Purpose in Life subscale. Functional health was measured by functional difficulties in mobility and daily living. Race (Black and White) and poverty status (above and below) were used as moderators to probe the purpose-functional health association using zero-inflated Poisson regression while adjusting for age, education, depressive symptomology, and previous functional difficulties in four hierarchical models. RESULTS Results showed that purpose in life was negatively associated with functional difficulty, indicating fewer difficulties in mobility and daily activities among those with a high sense of purpose. While the association did not remain significant after including previous functional difficulty as a covariate in Model 4, suggesting that race may not be a consistent moderator, poverty status remained a consistent moderator. The association was stronger for individuals above the poverty level. DISCUSSION These findings underscore the complex interplay between purpose in life, race, poverty status, and functional health, emphasizing the importance of considering socioeconomic factors in interventions aimed at eliminating functional health disparities among diverse adult populations.
Collapse
Affiliation(s)
- Shyuan Ching Tan
- Human Development Department, California State University San Marcos, 305 University Hall, San Marcos, CA, 92096-0001, USA.
| | | | - Michele K Evans
- Laboratory of Epidemiology and Population Science, National Institute on Aging, NIH, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Science, National Institute on Aging, NIH, Baltimore, MD, USA
| |
Collapse
|
3
|
Ryff CD. Contributions of Eudaimonic Well-Being to Mental Health Practice. MENTAL HEALTH AND SOCIAL INCLUSION 2023; 27:276-293. [PMID: 38188969 PMCID: PMC10769108 DOI: 10.1108/mhsi-12-2022-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Purpose Synergies between a eudaimonic model of psychological well-being (Ryff, 1989) and mental health practice are examined. The model grew out of clinical, developmental, existential, and humanistic perspectives that emphasized psychological strengths and capacities, in contrast to the focus on emotional distress and dysfunction in clinical psychology. Design/Approach Conceptual foundations of the eudaimonic approach are described, along with the six components positive functioning that are used to measure well-being. These qualities may be important in facilitating the recovery experiences, which are of interest in Mental Health and Social Inclusion. Findings Four categories of empirical evidence about eudaimonia are reviewed: (1) how it changes with aging, (2) how it matters for health, (3) what are its biological and neurological underpinnings, and (4) whether it can be promoted. Major contemporary forces against eudaimonia are also considered, including ever-widening inequality, the enduring pandemic, and world-wide strife. In contrast, encounters with the arts and nature are put forth as forces for eudaimonia. The relevance of these ideas for mental health research and practice is considered. Originality Mental health is often defined as the absence of mental illness. The novelty of the eudaimonic approach is to define mental health as the presence of well-being, assessed with different components of positive functioning. Practical Implications Enormous suffering defines our contemporary world. Such realities call for greater attention to factors that undermine as well as nurture the realization of human potential, the core of eudaimonic well-being.
Collapse
|
4
|
Berkowitz L, Mateo C, Salazar C, Samith B, Sara D, Pinto V, Martínez X, Calzada M, von Schultzendorff A, Pedrals N, Bitran M, Echeverría G, Ruini C, Ryff C, Rigotti A. Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7099. [PMID: 38063529 PMCID: PMC10705882 DOI: 10.3390/ijerph20237099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 12/18/2023]
Abstract
High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.
Collapse
Affiliation(s)
- Loni Berkowitz
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Camila Mateo
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Cristian Salazar
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Bárbara Samith
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Daniela Sara
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Victoria Pinto
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
- Carrera de Nutrición y Dietética and Centro de Nutrición Molecular y Enfermedades Crónicas, Facultad de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile
| | - Ximena Martínez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Mariana Calzada
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Andrea von Schultzendorff
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Nuria Pedrals
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Marcela Bitran
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Guadalupe Echeverría
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| | - Chiara Ruini
- Department for Life Qualities Studies, University of Bologna, 40126 Rimini, Italy;
| | - Carol Ryff
- Institute on Aging, University of Wisconsin-Madison, Madison, WI 53715-1149, USA;
| | - Attilio Rigotti
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (L.B.); (B.S.); (M.C.); (N.P.); (G.E.)
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8331150, Chile; (C.M.); (C.S.); (D.S.); (V.P.); (X.M.); (A.v.S.); (M.B.)
| |
Collapse
|
5
|
Kirsch JA, Coe C, Ryff CD. Racial and Educational Disparities in Cumulative Exposure to Hardships of the 2008 Great Recession and Inflammation. Psychosom Med 2023; 85:699-709. [PMID: 37506298 PMCID: PMC10543484 DOI: 10.1097/psy.0000000000001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVE This cross-sectional analysis examined self-reported economic hardships of the 2008 Great Recession, race/ethnicity, educational attainment, and psychological well-being (PWB) as predictors of systemic inflammatory physiology at midlife. We also tested for differential vulnerability in the relationship between recession hardship and inflammatory physiology by race/ethnicity, education, and PWB. METHODS Adults from the Midlife in the United States Refresher sample completed a survey and biomedical assessments after the recession ( n = 592 non-Hispanic White respondents, n = 158 Black/African American respondents, n = 108 respondents with other race/ethnicity). Cumulative recession hardship was the sum of financial, housing, and employment-related events. Outcomes included circulating levels of interleukin 6 and C-reactive protein. General linear regression models tested main effects interactions between primary predictor variables. RESULTS Educational attainment was inversely associated with recession hardships ( b = -0.18, 95% confidence interval = -0.26 to -0.11, p < .001). Black/African American respondents reported more recession hardships than White respondents ( b = 1.17, 95% confidence interval = 0.67 to 1.68, p < .001). More recession hardships predicted higher levels of interleukin 6 ( b = 0.06, p < .001) and C-reactive protein ( b = 0.04, p = .004). Analyses did not support race/ethnicity, education, and PWB as moderators of the association between recession hardship and inflammatory markers. CONCLUSIONS Race/ethnicity and education independently predicted disparities in cumulative recession hardship exposure. Recession hardship predicted higher blood levels of inflammatory proteins associated with long-term health. The lack of findings for differential vulnerability in the relationship between recession hardship and inflammatory markers by race/ethnicity, education, or PWB was possibly due to the limited sample size.
Collapse
Affiliation(s)
- Julie A. Kirsch
- Department of Family Medicine and Community Health and the Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison
| | - Christopher Coe
- Harlow Center for Biological Psychology, University of Wisconsin-Madison
| | - Carol D. Ryff
- Department of Psychology and the Institute on Aging, University of Wisconsin-Madison
| |
Collapse
|
6
|
Celano CM, Massey C, Long J, Kim S, Velasquez O, Healy BC, Wexler DJ, Madva EN, Huffman JC. An Adaptive, Algorithm-based Text Message Intervention to Promote Health Behavior Adherence in Type 2 Diabetes: Treatment Development and Proof-of-Concept Trial. J Diabetes Sci Technol 2023; 17:364-373. [PMID: 34911398 PMCID: PMC10012372 DOI: 10.1177/19322968211065067] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Most individuals with type 2 diabetes (T2D) struggle to adhere to one or more health behaviors. Text message interventions (TMIs) have the potential to improve adherence but have had mixed effects on diet and activity in T2D. We developed an eight-week, adaptive, algorithm-driven TMI to promote physical activity, diet, self-care, and well-being. Then, in a single-arm trial, we assessed its feasibility, acceptability, and preliminary efficacy in 15 individuals with T2D and suboptimal adherence. METHODS Participants received daily text messages and were asked to rate the utility of each message (0=not helpful, 10=very helpful). These ratings were used by an algorithm to select subsequent messages based on each participant's prior ratings. We assessed intervention feasibility by rates of message transmission/response and acceptability through ratings of message utility and burden. Finally, we examined pre-post changes in diabetes self-care, diet, physical activity, and psychological outcomes and calculated effect sizes (Cohen's d). RESULTS All text messages were delivered, and participants provided ratings for 79% of messages, above our a priori thresholds for feasibility. Participants rated the individual messages and overall TMI as subjectively useful (utility: 8.1 [SD=2.1] and 7.8 [SD=2.0], respectively) and not burdensome (burden: 0.8 [SD=1.8]). The intervention led to significant, medium- to large-sized improvements in self-care (d=0.77), diet (d=0.99), and activity (d=0.61) but minimal change in psychological outcomes. CONCLUSIONS The TMI was feasible and well-accepted, and it led to promising improvements in adherence-related outcomes. These findings should be confirmed in a larger randomized controlled trial.
Collapse
Affiliation(s)
- Christopher M. Celano
- Department of Psychiatry, Harvard
Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts
General Hospital, Boston, MA, USA
- Christopher M. Celano, MD, Department of
Psychiatry, Massachusetts General Hospital, 125 Nashua Street, Suite 324,
Boston, MA 02114, USA.
| | - Christina Massey
- Department of Psychiatry, Harvard
Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts
General Hospital, Boston, MA, USA
| | | | - Sonia Kim
- Department of Psychiatry, Massachusetts
General Hospital, Boston, MA, USA
- Harvard T.H. Chan School of Public
Health, Boston, MA, USA
| | - Olivia Velasquez
- Department of Psychiatry, Massachusetts
General Hospital, Boston, MA, USA
- Department of Psychiatry, McLean
Hospital, Belmont, MA, USA
| | - Brian C. Healy
- Department of Neurology, Brigham and
Women’s Hospital, Boston, MA, USA
- Departments of Neurology and
Biostatistics, Harvard Medical School, Boston, MA, USA
| | - Deborah J. Wexler
- Department of Medicine (Endocrinology),
Harvard Medical School, Boston, MA, USA
- Diabetes Unit, Massachusetts General
Hospital Diabetes Center, Boston, MA, USA
| | - Elizabeth N. Madva
- Department of Psychiatry, Harvard
Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts
General Hospital, Boston, MA, USA
| | - Jeff C. Huffman
- Department of Psychiatry, Harvard
Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts
General Hospital, Boston, MA, USA
| |
Collapse
|
7
|
PERMA Dimensions of Well-Being Among Diabetic and Non-Diabetic Adults: Evidence from Two Diabetic Care Hospitals in Odisha. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00677-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
|
8
|
Crosswell AD, Sagui-Henson S, Prather AA, Coccia M, Irwin MR, Epel ES. Psychological Resources and Biomarkers of Health in the Context of Chronic Parenting Stress. Int J Behav Med 2021; 29:175-187. [PMID: 34357581 PMCID: PMC8343363 DOI: 10.1007/s12529-021-10007-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 12/17/2022]
Abstract
Background Epidemiological studies link psychological resources to better physical health. One reason may be that psychological resources are protective in stressful contexts. This study tested whether indeed psychological resources are protective against biological degradation for healthy mid-life women under the chronic stress of caring for a child with an autism spectrum disorder diagnosis (“caregivers”). Methods We tested whether five types of psychosocial resources (i.e., eudaimonic well-being, autonomy, purpose in life, self-acceptance, and mastery) were associated with biological indices of aging in a sample of mid-life women stratified by chronic stress; half were caregivers (n = 92) and half were mothers of neurotypical children (n = 91; controls). Selected stress and age related biological outcomes were insulin resistance (HOMA-IR), systemic inflammation (IL-6, CRP), and cellular aging (leukocyte telomere length). We tested whether each resource was associated with these biomarkers, and whether caregiving status and high parenting stress moderated that relationship. Results All the psychological resources except mastery were significantly negatively associated with insulin resistance, while none were related to systemic inflammation or telomere length. The relationships between eudaimonic well-being and HOMA-IR, and self-acceptance and HOMA-IR, were moderated by parental stress; lower resources were associated with higher insulin resistance, but only for women reporting high parental stress. The well-known predictors of age and BMI accounted for 46% of variance in insulin resistance, and psychological resources accounted for an additional 13% of variance. Conclusion These findings suggest that higher eudaimonic well-being and greater self-acceptance may be protective for the metabolic health of mid-life women, and particularly in the context of high parenting stress. This has important implications given the rising rates of both parental stress and metabolic disease, and because psychological interventions can increase eudaimonic well-being and self-acceptance. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-021-10007-z.
Collapse
Affiliation(s)
- Alexandra D. Crosswell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 3333 California Street Suite 465, CA 94118 San Francisco, USA
| | - Sara Sagui-Henson
- Osher Center for Integrative Medicine, University of California, San Fransisco, CA San Francisco, USA
| | - Aric A. Prather
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 3333 California Street Suite 465, CA 94118 San Francisco, USA
| | - Michael Coccia
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 3333 California Street Suite 465, CA 94118 San Francisco, USA
| | - Michael R. Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA Los Angeles, USA
| | - Elissa S. Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 3333 California Street Suite 465, CA 94118 San Francisco, USA
| |
Collapse
|
9
|
Boehm JK. Positive psychological well‐being and cardiovascular disease: Exploring mechanistic and developmental pathways. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2021; 15:e12599. [PMID: 35860033 PMCID: PMC9285725 DOI: 10.1111/spc3.12599] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 01/15/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Abstract
Empirical research regarding the health benefits of positive psychological well‐being (e.g., positive emotions, life satisfaction, purpose in life, and optimism) has flourished in recent years, particularly with regard to cardiovascular disease. This paper reviews the state of evidence for well‐being's association with cardiovascular disease in both healthy individuals and those diagnosed with a disease. Prospective studies consistently indicate well‐being reduces cardiovascular events in healthy and, to a lesser extent, patient populations. Potential pathways that link well‐being with cardiovascular disease are discussed (including health behaviors, physiological processes, and stress buffering), although the existing evidence is mostly cross‐sectional which limits conclusions about directionality. Issues related to development across the lifespan are considered and childhood is identified as a crucial period for establishing healthy cardiovascular trajectories. Outstanding questions for future research are provided with recommendations to focus on well‐powered and prospective study designs with rigorous assessment of both well‐being and cardiovascular‐related outcomes.
Collapse
Affiliation(s)
- Julia K. Boehm
- Department of Psychology Chapman University Orange California USA
| |
Collapse
|
10
|
Yang HJ, Koh E, Sung MK, Kang H. Changes Induced by Mind-Body Intervention Including Epigenetic Marks and Its Effects on Diabetes. Int J Mol Sci 2021; 22:ijms22031317. [PMID: 33525677 PMCID: PMC7865217 DOI: 10.3390/ijms22031317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 12/20/2022] Open
Abstract
Studies have evidenced that epigenetic marks associated with type 2 diabetes (T2D) can be inherited from parents or acquired through fetal and early-life events, as well as through lifelong environments or lifestyles, which can increase the risk of diabetes in adulthood. However, epigenetic modifications are reversible, and can be altered through proper intervention, thus mitigating the risk factors of T2D. Mind-body intervention (MBI) refers to interventions like meditation, yoga, and qigong, which deal with both physical and mental well-being. MBI not only induces psychological changes, such as alleviation of depression, anxiety, and stress, but also physiological changes like parasympathetic activation, lower cortisol secretion, reduced inflammation, and aging rate delay, which are all risk factors for T2D. Notably, MBI has been reported to reduce blood glucose in patients with T2D. Herein, based on recent findings, we review the effects of MBI on diabetes and the mechanisms involved, including epigenetic modifications.
Collapse
Affiliation(s)
- Hyun-Jeong Yang
- Korea Institute of Brain Science, Seoul 06022, Korea; (M.-K.S.); (H.K.)
- Department of Integrative Health Care, University of Brain Education, Cheonan 31228, Korea
- Correspondence:
| | - Eugene Koh
- Temasek Life Sciences Laboratories, Singapore 117604, Singapore;
| | - Min-Kyu Sung
- Korea Institute of Brain Science, Seoul 06022, Korea; (M.-K.S.); (H.K.)
| | - Hojung Kang
- Korea Institute of Brain Science, Seoul 06022, Korea; (M.-K.S.); (H.K.)
| |
Collapse
|
11
|
Hoogendoorn CJ, Schechter CB, Llabre MM, Walker EA, Gonzalez JS. Distress and Type 2 Diabetes Self-Care: Putting the Pieces Together. Ann Behav Med 2020; 55:938-948. [PMID: 32914829 PMCID: PMC8489306 DOI: 10.1093/abm/kaaa070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Conflicting research emphasizes depression, diabetes distress, or well-being in relation to diabetes self-care and risk for poor health outcomes. PURPOSE The purpose of this study was to test whether a latent variable for general psychological distress derived from shared variance of depression symptoms, diabetes distress, and well-being predicts a latent variable of diabetes self-care and to examine evidence for unique effects once shared effects are adjusted for. METHODS Adults with suboptimally controlled diabetes were recruited from the South Bronx, NY, for a telephonic diabetes self-management support trial. Baseline diabetes self-care, medication adherence, depression symptoms, diabetes distress, and well-being were measured by validated self-report. Structural equation modeling specified a latent variable for general psychological distress derived from shared variance of depression symptoms, diabetes distress, and well-being. Diabetes self-care was a latent variable indicated by diet, glucose self-monitoring, and medication adherence. RESULTS Participants (N = 627, 65% female) were predominantly ethnic minority (70% Hispanic; 45% Black) and 77% reported household income <$20K/year. Mean (standard deviation) age = 56 (12) years; A1c = 9.1% (1.9%); body mass index = 32 (8) kg/m2. The latent variable for psychological distress was a robust predictor of poorer diabetes self-care (coefficient = -0.59 [confidence interval = -0.71, -0.46], p < .001) with good model fit. Unique paths from depression symptoms, diabetes distress, and well-being (all ps > .99) to self-care were not observed. CONCLUSIONS In this population of disadvantaged adults with suboptimally controlled diabetes, general psychological distress was strongly associated with poorer diabetes self-care and fully accounted for the effects of depression, diabetes distress, and positive well-being. This suggests that general distress may underlie previously reported associations between these constructs and diabetes self-care.
Collapse
Affiliation(s)
- Claire J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA,Claire J. Hoogendoorn
| | - Clyde B Schechter
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Elizabeth A Walker
- Departments of Medicine (Endocrinology) and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA,The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY, USA,The New York Regional Center for Diabetes Translation Research (NY-CDTR), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA,Departments of Medicine (Endocrinology) and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA,The Fleischer Institute for Diabetes and Metabolism, Albert Einstein College of Medicine, Bronx, NY, USA,The New York Regional Center for Diabetes Translation Research (NY-CDTR), Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
12
|
Poole L, Hackett RA, Panagi L, Steptoe A. Subjective wellbeing as a determinant of glycated hemoglobin in older adults: longitudinal findings from the English Longitudinal Study of Ageing. Psychol Med 2020; 50:1820-1828. [PMID: 31456532 PMCID: PMC7477365 DOI: 10.1017/s0033291719001879] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/25/2019] [Accepted: 07/08/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Previous research has shown an association between subjective wellbeing and incident diabetes. Less is known about the role of wellbeing for subclinical disease trajectories as captured via glycated hemoglobin (HbA1c). We aimed to explore the association between subjective wellbeing and future HbA1c levels, and the role of sociodemographic, behavioral and clinical factors in this association. METHODS We used data from the English Longitudinal Study of Ageing for this study (N = 2161). Subjective wellbeing (CASP-19) was measured at wave 2 and HbA1c was measured 8 years later at wave 6. Participants were free from diabetes at baseline. We conducted a series of analyses to examine the extent to which the association was accounted for by a range of sociodemographic, behavioral and clinical factors in linear regression models. RESULTS Models showed that subjective wellbeing (CASP-19 total score) was inversely associated with HbA1c 8 years later after controlling for depressive symptoms, age, sex, and baseline HbA1c (B = -0.035, 95% CI -0.060 to -0.011, p = 0.005). Inclusion of sociodemographic variables and behavioral factors in models accounted for a large proportion (17.0% and 24.5%, respectively) of the relationship between wellbeing and later HbA1c; clinical risk factors explained a smaller proportion of the relationship (3.4%). CONCLUSIONS Poorer subjective wellbeing is associated with greater HbA1c over 8 years of follow-up and this relationship can in part be explained by sociodemographic, behavioral and clinical factors among older adults.
Collapse
Affiliation(s)
- Lydia Poole
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Ruth A. Hackett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Laura Panagi
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| |
Collapse
|
13
|
Woo J, Lehrer HM, Whyne E, Steinhardt M. The longitudinal association of psychological resources with chronic conditions and the mediating roles of health behaviours and allostatic load. Psychol Health 2020; 35:629-643. [PMID: 31549526 PMCID: PMC7769193 DOI: 10.1080/08870446.2019.1656205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 07/22/2019] [Accepted: 08/09/2019] [Indexed: 01/19/2023]
Abstract
Objective: To investigate the association of psychological resources with the prevalence of chronic conditions up to 10 years later, and the mediating roles of health behaviours and allostatic load. Design: Participants from the Midlife in the United States study (N = 850) completed surveys and biomarker assessments over the course of 10 years. Main Outcome Measures: Primary outcome was the prevalence of chronic conditions later in life, controlling for baseline chronic conditions. Secondary outcomes were health behaviours and allostatic load. Direct and indirect associations between psychological resources and chronic conditions were examined. Results: Psychological resources were negatively associated with chronic conditions directly (ƅ = -.177, p < .05) and indirectly through health behaviours (ƅ = -.026, p < .05), but not through allostatic load (ƅ = -.000, p > .05). Psychological resources were positively associated with health behaviours (ƅ = .130, p < .01), but no association was found between psychological resources and allostatic load (ƅ = -.002, p > .05). Health behaviours were negatively associated with chronic conditions (ƅ = -.201, p < .01), and allostatic load was positively associated with chronic conditions (ƅ = .197, p < .05). Conclusion: Findings highlight the beneficial influence of psychological resources on chronic conditions, and the mediating role of health behaviours.
Collapse
Affiliation(s)
- Jihun Woo
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| | - H Matthew Lehrer
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| | - Erum Whyne
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| | - Mary Steinhardt
- Department of Kinesiology & Health Education, College of Education, The University of Texas at Austin, Texas, USA
| |
Collapse
|
14
|
Mantantzis K, Drewelies J, Duezel S, Buchmann N, Steinhagen-Thiessen E, Wagner GG, Raz N, Lindenberger U, Demuth I, Gerstorf D. Poor glucose regulation is associated with declines in well-being among older men, but not women. Psychol Aging 2020; 35:204-211. [PMID: 31724413 PMCID: PMC7042050 DOI: 10.1037/pag0000404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Glucose regulation is a key aspect of healthy aging and has been linked to brain functioning and cognition. Here we examined the role of glucose regulation for within-person longitudinal trajectories of well-being. We applied growth models to data from the Berlin Aging Study II (N = 955), using insulin resistance as an index of glucoregulatory capacity. We found that poor glucose regulation (higher insulin resistance) was consistently associated with lower levels of well-being among older men but not women. Our study provides novel evidence for the relevance of glucose regulation for well-being among older men. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
| | | | | | | | | | - Gert G. Wagner
- Max Planck Institute for Human Development
- German Institute for Economic Research (DIW) Berlin
| | - Naftali Raz
- Max Planck Institute for Human Development
- Wayne State University, USA
| | - Ulman Lindenberger
- Max Planck Institute for Human Development
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin
| | | | - Denis Gerstorf
- Humboldt University Berlin
- German Institute for Economic Research (DIW) Berlin
| |
Collapse
|
15
|
Ogunmoroti O, Utuama OA, Salami JA, Valero-Elizondo J, Spatz ES, Rouseff M, Parris D, Das S, Guzman H, Agatston A, Feldman T, Veledar E, Maziak W, Nasir K. Association between self-rated health and ideal cardiovascular health: The Baptist Health South Florida Employee Study. J Public Health (Oxf) 2019; 40:e456-e463. [PMID: 29045671 DOI: 10.1093/pubmed/fdx140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2017] [Indexed: 11/13/2022] Open
Abstract
Background There is increasing evidence of the role psychosocial factors play as determinants of cardiovascular health (CVH). We examined the association between self-rated health (SRH) and ideal CVH among employees of a large healthcare organization. Methods Data were collected in 2014 from employees of Baptist Health South Florida during an annual voluntary health risk assessment and wellness fair. SRH was measured using a self-administered questionnaire where responses ranged from poor, fair, good, very good to excellent. A CVH score (the proxy for CVH) that ranged from 0 to 14 was calculated, where 0-8 indicate an inadequate score, 9-10, average and 11-14, optimal. A multinomial logistic regression was used to examine the association between SRH and CVH. Results Of the 9056 participants, 75% were female and mean age (SD) was 43 ± 12 years. The odds of having a higher CVH score increased as SRH improved. With participants who reported their health status as poor-fair serving as reference, adjusted odds ratios for having an optimal CVH score by the categories of SRH were: excellent, 21.04 (15.08-29.36); very good 10.04 (7.25-13.9); and good 3.63 (2.61-5.05). Conclusion Favorable SRH was consistently associated with better CVH.
Collapse
Affiliation(s)
- Oluseye Ogunmoroti
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA.,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Ovie A Utuama
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Joseph A Salami
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA
| | - Javier Valero-Elizondo
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT, USA.,Section of Cardiovascular Medicine, Yale University, New Haven, CT, USA
| | - Maribeth Rouseff
- Wellness Advantage Administration, Baptist Health South Florida, Miami, FL, USA
| | - Don Parris
- Center for Research and Grants, Baptist Health South Florida, Miami, FL, USA
| | - Sankalp Das
- Wellness Advantage Administration, Baptist Health South Florida, Miami, FL, USA
| | - Henry Guzman
- Employee Health Management, Baptist Health South Florida, Miami, FL, USA
| | - Arthur Agatston
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA.,South Beach Preventive Cardiology, Miami Beach, FL, USA
| | - Theodore Feldman
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA.,Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Emir Veledar
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA.,Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Khurram Nasir
- Center for Healthcare Advancement and Outcomes, Baptist Health South Florida, Miami, FL, USA.,Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.,The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.,Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, FL, USA
| |
Collapse
|
16
|
Kim ES, Delaney SW, Kubzansky LD. Sense of Purpose in Life and Cardiovascular Disease: Underlying Mechanisms and Future Directions. Curr Cardiol Rep 2019; 21:135. [PMID: 31673815 PMCID: PMC10683927 DOI: 10.1007/s11886-019-1222-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE OF REVIEW In this review, we synthesize recent research that has reported associations of a higher sense of purpose in life with reduced risk of developing cardiovascular disease (CVD), and then explore mechanisms that might underlie these associations. RECENT FINDINGS Accumulating observational and experimental evidence suggests that having a higher sense of purpose might influence CVD risk through three pathways: (1) enhancement of other psychological and social resources that buffer against the cardiotoxic effects of overwhelming stress; (2) indirect effects through health behaviors; and (3) direct effects on biological pathways. A sense of purpose in life is emerging as an independent risk factor for incident CVD. A key remaining question is whether purpose causally effects CVD risk; in the "Future Research Directions" section, we focus on work needed to establish causality and provide suggestions for next steps.
Collapse
Affiliation(s)
- Eric S Kim
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA.
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, Cambridge, MA, USA.
| | - Scott W Delaney
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA
| | - Laura D Kubzansky
- Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02215, USA
- Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
17
|
Peterson L, Ralston M. Aging well in an aging world: The impact of material conditions, culture, and societal disruptions. Soc Sci Med 2019; 220:245-253. [DOI: 10.1016/j.socscimed.2018.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/28/2018] [Accepted: 11/13/2018] [Indexed: 11/28/2022]
|
18
|
Osibogun O, Ogunmoroti O, Spatz ES, Burke GL, Michos ED. Is self-rated health associated with ideal cardiovascular health? The Multi-Ethnic Study of Atherosclerosis. Clin Cardiol 2018; 41:1154-1163. [PMID: 29896874 PMCID: PMC6173615 DOI: 10.1002/clc.22995] [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: 04/17/2018] [Revised: 06/05/2018] [Accepted: 06/10/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Self-rated health (SRH) is an indicator of health status-a determinant of health-promoting behaviors and a predictor of morbidity/mortality. Little is known about the association between SRH and ideal cardiovascular health (CVH), as measured by the AHA Life's Simple 7 (LS7) metrics, or whether the relationship between SRH and CVH differs by race/ethnicity. HYPOTHESIS Favorable SRH is associated with better CVH. METHODS We conducted a cross-sectional analysis of 6457 men and women (4 race/ethnicities) who participated in the Multi-Ethnic Study of Atherosclerosis. SRH was measured on a 5-point Likert scale (excellent, very good, good, fair, and poor). CVH was assessed using the LS7 metrics, each scored from 0 to 2, with a total score of 0 to 14. Scores of 0 to 8 indicate inadequate, 9 to 10, average, and 11 to 14, optimal CVH. ORs and 95% CIs were calculated for associations between SRH and CVH scores using multinomial logistic regression, adjusted for age, sex, race/ethnicity, education, income, marital status, health insurance, and chronic diseases. RESULTS Mean age of participants was 62 ± 10 years; 53% were female. Odds of ideal CVH increased as SRH improved. Compared with poor-fair SRH, adjusted ORs and 95% CIs for optimal CVH by SRH status were excellent, 4.9 (3.4-7.0); very good, 2.2 (1.6-3.1); and good, 1.5 (1.1-2.1). Results were similar by race/ethnicity, sex, and age groups. CONCLUSIONS More favorable SRH was associated with better CVH, irrespective of sex, race/ethnicity, or age. Further research could explore whether optimization of SRH predicts CVH.
Collapse
Grants
- HHSN268201500003C NHLBI NIH HHS
- UL1-RR-025005 National Center for Research Resources (NCRR)
- N01-HC-95162 National Heart, Lung, and Blood Institute (NHLBI)
- N01-HC-95167 National Heart, Lung, and Blood Institute (NHLBI)
- Blumenthal Scholars Fund for Preventive Cardiology Johns Hopkins University
- N01-HC-95159 National Heart, Lung, and Blood Institute (NHLBI)
- N01-HC-95169 National Heart, Lung, and Blood Institute (NHLBI)
- N01-HC-95164 National Heart, Lung, and Blood Institute (NHLBI)
- N01-HC-95160 National Heart, Lung, and Blood Institute (NHLBI)
- N01 HC095162 NHLBI NIH HHS
- UL1-RR-024156 National Center for Research Resources (NCRR)
- N01-HC-95165 National Heart, Lung, and Blood Institute (NHLBI)
- HHSN268201500003I NHLBI NIH HHS
- N01-HC-95166 National Heart, Lung, and Blood Institute (NHLBI)
- N01-HC-95163 National Heart, Lung, and Blood Institute (NHLBI)
- N01 HC095165 NHLBI NIH HHS
- HHSN268201500003I NHLBI NIH HHS
- N01-HC-95168 National Heart, Lung, and Blood Institute (NHLBI)
- N01-HC-95161 National Heart, Lung, and Blood Institute (NHLBI)
Collapse
Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFlorida
| | - Oluseye Ogunmoroti
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular DiseaseBaltimoreMaryland
| | - Erica S. Spatz
- Section of Cardiovascular Medicine, Yale School of MedicineNew HavenConnecticut
| | - Gregory L. Burke
- Division of Public Health Sciences, Wake Forest School of MedicineWinston‐SalemNorth Carolina
| | - Erin D. Michos
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular DiseaseBaltimoreMaryland
| |
Collapse
|
19
|
Harris KM, Schorpp KM. Integrating Biomarkers in Social Stratification and Health Research. ANNUAL REVIEW OF SOCIOLOGY 2018; 44:361-386. [PMID: 30918418 PMCID: PMC6433161 DOI: 10.1146/annurev-soc-060116-053339] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This article provides an overview of the integration of biomarkers and biological mechanisms in social science models of stratification and health. The goal in reviewing this literature is to highlight research that identifies the social forces that drive inequalities over the life course and across generations. The article is structured in the following way. First, descriptive background information on biomarkers is presented, followed secondly by a review of the general theoretical paradigms that lend themselves to an integrative approach. Third, the biomarkers used to capture several biological systems that are most responsive to social conditions are described. Fourth, research that explicates how social exposures "get under the skin" to affect physiological functioning and downstream health is discussed, using socioeconomic disadvantage as an illustrative social exposure. The review ends with emerging directions in the use of biomarkers in social science research. This article endeavors to encourage sociologists to embrace biosocial approaches in order to elevate the importance of social factors in biomedical processes and to intervene on the social conditions that create inequities.
Collapse
|
20
|
Morimoto Y, Yamasaki S, Ando S, Koike S, Fujikawa S, Kanata S, Endo K, Nakanishi M, Hatch SL, Richards M, Kasai K, Hiraiwa-Hasegawa M, Nishida A. Purpose in life and tobacco use among community-dwelling mothers of early adolescents. BMJ Open 2018; 8:e020586. [PMID: 29678982 PMCID: PMC5914705 DOI: 10.1136/bmjopen-2017-020586] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES The rising prevalence of tobacco use and tobacco-attributable deaths among women is of worldwide concern. In particular, smoking prevention for mothers in early midlife is a significant international public health goal. A higher sense of purpose in life (PIL) is thought to reduce detrimental health behaviours. However, little is known about the association between a sense of PIL and tobacco use. This study investigates this association among community-dwelling mothers of early adolescents. DESIGN This population-based cross-sectional study uses a self-reported questionnaire from the Tokyo Early Adolescence Survey, a large community-based survey conducted in Japan between 2012 and 2015. SETTING Participants were randomly recruited from the resident registries of three municipalities in Tokyo, Japan. PARTICIPANTS A total of 4478 children and their primary parents participated. Responses from 4063 mothers with no missing data were analysed (mean age=42.0 years (SD=4.2)). MEASURES Participants' tobacco use, including the number of cigarettes smoked per day, was documented using a questionnaire. PIL was assessed using a Purpose in Life scale derived from Ryff's Psychological Well-Being Scale. RESULTS Greater PIL was associated with a decreased likelihood of tobacco use, even when adjusted for confounders (OR=0.80, 95% CI 0.70 to 0.91). Multinomial logistic regression analyses revealed that PIL was inversely associated with tobacco consumption among mothers. These associations remained after controlling for psychological distress, socioeconomic factors and frequency of alcohol consumption among moderate to heavy smokers (OR=0.70, 95% CI 0.57 to 0.86), while attenuated among light smokers. CONCLUSIONS Increasing PIL may be a valuable intervention for reducing tobacco use among women in early midlife. This study can contribute to our understanding of the psychology of smoking behaviour and shed light on the targeted intervention to reduce tobacco use among early midlife mothers.
Collapse
Affiliation(s)
- Yuko Morimoto
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Syudo Yamasaki
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinsuke Koike
- University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Kaori Endo
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Miharu Nakanishi
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Aging, University College London, London, UK
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (The Graduate University for Advanced Studies), Kanagawa, Japan
| | - Atsushi Nishida
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| |
Collapse
|
21
|
Radler BT, Rigotti A, Ryff CD. Persistently high psychological well-being predicts better HDL cholesterol and triglyceride levels: findings from the midlife in the U.S. (MIDUS) longitudinal study. Lipids Health Dis 2018; 17:1. [PMID: 29298716 PMCID: PMC5751819 DOI: 10.1186/s12944-017-0646-8] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/17/2017] [Indexed: 11/23/2022] Open
Abstract
Background Psychological correlates of blood lipid levels have been previously evaluated mostly in cross sectional studies. However, prospectively measured psychological factors might also predict favorable blood lipid profiles, thereby indicating a healthy mind/body interplay that is associated with less disease, better health and longer lives. Methods This paper examined whether longitudinal profiles of psychological well-being over 9–10 years are predictors of blood lipid profiles. Using the MIDUS (Midlife in the U.S.) biological subsample (n = 1054, aged 34 to 84, 55% female), cross-time trajectories of well-being were linked with three lipid outcomes (i.e., HDL cholesterol, triglycerides, and LDL cholesterol), measured for the first time at the 2nd wave of the study. Results Most adults showed largely stable profiles of well-being, albeit at different levels. Some showed persistently high well-being over time, while others revealed persistently low or moderate well-being. After adjusting for the effect of demographics, health behaviors, medications, and insulin resistance, adults with persistently high levels of environmental mastery and self-acceptance—two components of psychological well-being—had significantly higher levels of HDL as well as significantly lower levels of triglycerides compared to adults with persistently low levels of well-being. Converging with prior findings, no association was found between well-being and LDL cholesterol. Conclusions Over 9–10 years, persistently high levels of psychological well-being measures predicted high HDL cholesterol and low triglycerides. These findings add longitudinal evidence to the growing body of research showing that positive psychological factors are linked with better lipoprotein profiles. A better blood lipid profile, particularly higher HDL-C, may be key in mediating how psychological well-being positively impacts health and length of life. Additional research is required to further validate this hypothesis as well as to establish potential underlying mechanisms.
Collapse
Affiliation(s)
- Barry T Radler
- University of Wisconsin-Madison Institute on Aging, 2245 Medical Science Center, Madison, WI, 53703, USA.
| | - Attilio Rigotti
- Departamento de Gastroenterología, Pontificia Universidad Católica, Marcoleta #367, interior, Santiago, Chile
| | - Carol D Ryff
- University of Wisconsin-Madison Institute on Aging, 2245 Medical Science Center, Madison, WI, 53703, USA
| |
Collapse
|
22
|
Hernandez R, Bassett SM, Boughton SW, Schuette SA, Shiu EW, Moskowitz JT. Psychological Well-being and Physical Health: Associations, Mechanisms, and Future Directions. EMOTION REVIEW 2018; 10:18-29. [PMID: 36650890 PMCID: PMC9841922 DOI: 10.1177/1754073917697824] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A paradigm shift in public health and medicine has broadened the field from a singular focus on the ill effects of negative states and psychopathology to an expanded view that examines protective psychological assets that may promote improved physical health and longevity. We summarize recent evidence of the link between psychological well-being (including positive affect, optimism, life meaning and purpose, and life satisfaction) and physical health, with particular attention to outcomes of mortality and chronic disease incidence and progression. Within this evolving discipline there remain controversies and lessons to be learned. We discuss measurement-related challenges, concerns about the quality of the evidence, and other shortcomings in the field, along with a brief discussion of hypothesized biobehavioral mechanisms involved. Finally, we suggest next steps to move the field forward.
Collapse
Affiliation(s)
- Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Sarah M. Bassett
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Seth W. Boughton
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL
| | - Stephanie A. Schuette
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Eva W. Shiu
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Judith T. Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
23
|
Abstract
Psychological stress is common in many physical illnesses and is increasingly recognized as a risk factor for disease onset and progression. An emerging body of literature suggests that stress has a role in the aetiology of type 2 diabetes mellitus (T2DM) both as a predictor of new onset T2DM and as a prognostic factor in people with existing T2DM. Here, we review the evidence linking T2DM and psychological stress. We highlight the physiological responses to stress that are probably related to T2DM, drawing on evidence from animal work, large epidemiological studies and human laboratory trials. We discuss population and clinical studies linking psychological and social stress factors with T2DM, and give an overview of intervention studies that have attempted to modify psychological or social factors to improve outcomes in people with T2DM.
Collapse
Affiliation(s)
- Ruth A Hackett
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| |
Collapse
|
24
|
Krause N, Emmons RA, Ironson G, Hill PC. General feelings of gratitude, gratitude to god, and hemoglobin A1c: Exploring variations by gender. JOURNAL OF POSITIVE PSYCHOLOGY 2017. [DOI: 10.1080/17439760.2017.1326520] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Neal Krause
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Robert A. Emmons
- Department of Psychology, University of California, Davis, CA, USA
| | - Gail Ironson
- Department of Psychology, Miami University, Miami, FL, USA
| | - Peter C. Hill
- Department of Psychology, Biola University, La Mirada, CA, USA
| |
Collapse
|
25
|
Boylan JM, Tsenkova VK, Miyamoto Y, Ryff CD. Psychological resources and glucoregulation in Japanese adults: Findings from MIDJA. Health Psychol 2017; 36:449-457. [PMID: 28192004 PMCID: PMC5398939 DOI: 10.1037/hea0000455] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine associations between glucoregulation and 3 categories of psychological resources: hedonic well-being (i.e., life satisfaction, positive affect), eudaimonic well-being (i.e., personal growth, purpose in life, ikigai), and interdependent well-being (i.e., gratitude, peaceful disengagement, adjustment) among Japanese adults. The question is important given increases in rates of type 2 diabetes in Japan in recent years, combined with the fact that most prior studies linking psychological resources to better physical health have utilized Western samples. METHOD Data came from the Midlife in Japan Study involving randomly selected participants from the Tokyo metropolitan area, a subsample of whom completed biological data collection (N = 382; 56.0% female; M(SD)age = 55.5(14.0) years). Glycosylated hemoglobin (HbA1c) was the outcome. Models adjusted for age, gender, educational attainment, smoking, alcohol, chronic conditions, body mass index (BMI), use of antidiabetic medication, and negative affect. RESULTS Purpose in life (β = -.104, p = .021) was associated with lower HbA1c, and peaceful disengagement (β = .129, p = .003) was associated with higher HbA1c in fully adjusted models. Comparable to the effects of BMI, a 1 standard deviation change in well-being was associated with a .1% change in HbA1c. CONCLUSIONS Associations among psychological resources and glucoregulation were mixed. Healthy glucoregulation was evident among Japanese adults with higher levels of purpose in life and lower levels of peaceful disengagement, thereby extending prior research from the United States. The results emphasize the need for considering sociocultural contexts in which psychological resources are experienced in order to understand linkages to physical health. (PsycINFO Database Record
Collapse
Affiliation(s)
| | | | | | - Carol D Ryff
- Department of Psychology, and Institute on Aging, University of Wisconsin
| |
Collapse
|
26
|
Ryff CD. Eudaimonic well-being, inequality, and health: Recent findings and future directions. ACTA ACUST UNITED AC 2017; 64:159-178. [PMID: 29057014 DOI: 10.1007/s12232-017-0277-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The theoretical and philosophical underpinnings of a eudaimonic model of well-being are examined and its empirical translation into distinct dimensions of well-being is described. Empirical findings have documented aging declines in eudaimonic well-being, but there is considerable variability within age groups. Among older adults who remain purposefully engaged, health benefits (reduced morbidity, extended longevity) have been documented. Eudaimonic well-being also appears to offer a protective buffer against increased health risk among the educationally disadvantaged. Neural and genetic mechanisms that may underlie eudaimonic influences on health are briefly noted, and interventions designed to promote eudaimonic well-being are sketched. Needed future research directions include addressing problems of unjust societies wherein greed among privileged elites may be a force compromising the eudaimonic well-being of those less privileged. Alternatively, and more positive in focus, is the need to better understand the role of the arts, broadly defined, in promoting eudaimonic well-being across all segments of society.
Collapse
Affiliation(s)
- Carol D Ryff
- Institute on Aging/Department of Psychology, University of Wisconsin-Madison, 1300 University Ave., 2245 MSC, Madison, WI 53706,
| |
Collapse
|
27
|
Boehm JK, Chen Y, Williams DR, Ryff CD, Kubzansky LD. Subjective well-being and cardiometabolic health: An 8-11year study of midlife adults. J Psychosom Res 2016; 85:1-8. [PMID: 27212662 PMCID: PMC4889157 DOI: 10.1016/j.jpsychores.2016.03.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 01/19/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Individuals who are satisfied and experience frequent positive emotions tend to have reduced risk for coronary heart disease (CHD). However, conflicting evidence exists and little research has investigated whether well-being is associated with early-warning indicators of biological risk that precede CHD. We investigated whether life satisfaction and positive emotions longitudinally predicted reduced risk of incident cardiometabolic conditions and healthier cardiometabolic risk scores, which may provide insight into underlying mechanisms and novel prevention targets. METHODS Initially healthy men and women (N=754-854) reported their baseline life satisfaction and positive emotions. During follow-up, presence of manifest cardiometabolic conditions was assessed and a separate cardiometabolic risk score was constructed from eight biomarkers. Poisson and linear regression analyses tested whether life satisfaction and positive emotions were associated with reduced incident disease risk and lower cardiometabolic risk scores 8-11years later. RESULTS Life satisfaction and positive emotions were each prospectively associated with reduced risk of manifest conditions, controlling for demographics and family history of CHD. Associations were attenuated for positive emotions after adjusting for depressive symptoms and for life satisfaction after adjusting for health behaviors. Life satisfaction was associated with lower cardiometabolic risk scores until adding health behaviors, but positive emotions were not (regardless of the included covariates). CONCLUSION Well-being, particularly life satisfaction, is associated with reduced risk for incident cardiometabolic conditions in minimally-adjusted models. However, accounting for underlying behavioral pathways attenuates the association. Low levels of life satisfaction (but not positive emotions) may also provide early warning of cardiometabolic risk prior to disease development.
Collapse
Affiliation(s)
- Julia K. Boehm
- Department of Psychology, Chapman University, One University Drive, Orange, CA 92866
| | - Ying Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115,Department of African and African American Studies and Sociology, Harvard University, Cambridge, MA 02138
| | - Carol D. Ryff
- Department of Psychology, University of Wisconsin, Madison, 1202 West Johnson Street, Madison, WI 53706,Institute on Aging, University of Wisconsin, Madison, 1300 University Avenue, Madison, WI 53706
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115
| |
Collapse
|
28
|
Eudaimonia, Aging, and Health: A Review of Underlying Mechanisms. HANDBOOK OF EUDAIMONIC WELL-BEING 2016. [DOI: 10.1007/978-3-319-42445-3_24] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
29
|
Optimism and Cardiovascular Health: Multi-Ethnic Study of Atherosclerosis (MESA). HEALTH BEHAVIOR AND POLICY REVIEW 2015. [PMID: 26213688 DOI: 10.14485/hbpr.2.1.6] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES We examined the cross-sectional association between optimism and cardiovascular health (CVH). METHODS We used data collected from adults aged 52-84 who participated in the Multi-Ethnic Study of Atherosclerosis (MESA) (n=5,134) during the first follow-up visit (2002-2004). Multinomial logistic regression was used to examine associations of optimism with ideal and intermediate CVH (with reference being poor CVH), after adjusting for socio-demographic factors and psychological ill-being. RESULTS Participants in the highest quartile of optimism were more likely to have intermediate [OR=1.51:95%CI=1.25,1.82] and ideal [OR=1.92:95%CI=1.30,2.85] CVH when compared to the least optimistic group. Individual CVH metrics of diet, physical activity, BMI, smoking, blood sugar and total cholesterol contributed to the overall association. CONCLUSIONS We offer evidence for a cross-sectional association between optimism and CVH.
Collapse
|
30
|
Huffman JC, DuBois CM, Millstein RA, Celano CM, Wexler D. Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development. J Diabetes Res 2015; 2015:428349. [PMID: 26064980 PMCID: PMC4442018 DOI: 10.1155/2015/428349] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/02/2015] [Indexed: 12/21/2022] Open
Abstract
Most patients with type 2 diabetes (T2D) have suboptimal adherence to recommended diet, physical activity, and/or medication. Current approaches to improve health behaviors in T2D have been variably effective, and successful interventions are often complex and intensive. It is therefore vital to develop interventions that are simple, well-accepted, and applicable to a wide range of patients who suffer from T2D. One approach may be to boost positive psychological states, such as positive affect or optimism, as these constructs have been prospectively and independently linked to improvements in health behaviors. Positive psychology (PP) interventions, which utilize systematic exercises to increase optimism, well-being, and positive affect, consistently increase positive states and are easily delivered to patients with chronic illnesses. However, to our knowledge, PP interventions have not been formally tested in T2D. In this paper, we review a theoretical model for the use of PP interventions to target health behaviors in T2D, describe the structure and content of a PP intervention for T2D patients, and describe baseline data from a single-arm proof-of-concept (N = 15) intervention study in T2D patients with or without depression. We also discuss how PP interventions could be combined with motivational interviewing (MI) interventions to provide a blended psychological-behavioral approach.
Collapse
Affiliation(s)
- Jeff C. Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- *Jeff C. Huffman:
| | - Christina M. DuBois
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Rachel A. Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Christopher M. Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
| | - Deborah Wexler
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
- MGH Diabetes Center, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| |
Collapse
|
31
|
Ryff CD. Psychological well-being revisited: advances in the science and practice of eudaimonia. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 83:10-28. [PMID: 24281296 PMCID: PMC4241300 DOI: 10.1159/000353263] [Citation(s) in RCA: 833] [Impact Index Per Article: 83.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 05/27/2013] [Indexed: 11/19/2022]
Abstract
This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered.
Collapse
|
32
|
Celano CM, Beale EE, Moore SV, Wexler DJ, Huffman JC. Positive psychological characteristics in diabetes: a review. Curr Diab Rep 2013; 13:917-29. [PMID: 24048687 DOI: 10.1007/s11892-013-0430-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Positive psychological characteristics, such as optimism, self-efficacy, and resilience, have been increasingly associated with improved outcomes in medically ill individuals. However, there has been minimal systematic review of these characteristics and their associations with outcomes in people with diabetes. We aim to review these associations, their potential mediating mechanisms, and the evidence supporting interventions targeting these qualities. In people with diabetes, positive psychological characteristics are significantly associated with improved glycemic control, fewer complications, and reduced rates of mortality. Potential mechanisms mediating these associations include behavioral factors (e.g., improved treatment adherence), reduced inflammation, and improved neuroendocrine and autonomic functioning. Most psychosocial treatments in this population have focused on improving self-efficacy and resilience; such interventions may improve quality of life, well-being, and diabetes self-care. While untested in diabetes, interventions to boost other positive characteristics have been effective in other medically ill patients and may warrant further study in this cohort.
Collapse
|
33
|
Song J, Mailick MR, Ryff CD, Coe CL, Greenberg JS, Hong J. Allostatic load in parents of children with developmental disorders: moderating influence of positive affect. J Health Psychol 2013; 19:262-72. [PMID: 23300048 DOI: 10.1177/1359105312468193] [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] [Indexed: 11/17/2022] Open
Abstract
This study examines whether parents of children with developmental disorders are at risk of elevated allostatic load relative to control parents and whether positive affect moderates difference in risk. In all, 38 parents of children with developmental disorders and 38 matched comparison parents were analyzed. Regression analyses revealed a significant interaction between parent status and positive affect: parents of children with developmental disorders had lower allostatic load when they had higher positive affect, whereas no such association was evident for comparison parents. The findings suggest that promoting greater positive affect may lower health risks among parents of children with developmental disorders.
Collapse
|
34
|
Abubakari AR, Jones MC, Lauder W, Kirk A, Anderson J, Devendra D. Associations between knowledge, illness perceptions, self-management and metabolic control of type 2 diabetes among African and European-origin patients. ACTA ACUST UNITED AC 2011. [DOI: 10.1111/j.1752-9824.2011.01098.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
35
|
Shirom A, Toker S, Melamed S, Berliner S, Shapira I. Life and Job Satisfaction as Predictors of the Incidence of Diabetes. Appl Psychol Health Well Being 2011; 4:31-48. [PMID: 26286969 DOI: 10.1111/j.1758-0854.2011.01054.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We studied the hypothesised effects of baseline levels of life satisfaction and of job satisfaction on the incidence of diabetes. Participants were 2,305 apparently healthy men and women who underwent routine health checks at two points in time, about 20 months apart. New cases of diabetes (N=104) were defined based on fasting glucose value > 125, or glycosylated hemoglobin value > 6.5, or self-reported physician diagnosis of diabetes and taking medications to treat it. Life satisfaction was measured using the scale constructed by Diener et al. (1985) while job satisfaction was assessed based on the Survey of Working Conditions. In the analyses, we controlled for socio-demographic predictors, for known physiological and behavioral precursors of diabetes, and for depressive symptoms. There was support for our hypothesis that the higher the baseline levels of life satisfaction, the lower the incidence of diabetes. However, job satisfaction did not predict the incidence of diabetes. We obtained the same results when limiting the analysis to new cases of diabetes based on objective criteria only and when using as predictors both life and job satisfaction. We suggest that life satisfaction could be a protective factor reducing the risk of diabetes.
Collapse
Affiliation(s)
- Arie Shirom
- Faculty of Management, Tel Aviv University, Israel.
| | - Sharon Toker
- Tel Aviv University, IsraelTel Aviv Yaffo Academic College, IsraelTel Aviv Sourasky Medical Center, Israel
| | - Samuel Melamed
- Tel Aviv University, IsraelTel Aviv Yaffo Academic College, IsraelTel Aviv Sourasky Medical Center, Israel
| | - Shlomo Berliner
- Tel Aviv University, IsraelTel Aviv Yaffo Academic College, IsraelTel Aviv Sourasky Medical Center, Israel
| | - Itzhak Shapira
- Tel Aviv University, IsraelTel Aviv Yaffo Academic College, IsraelTel Aviv Sourasky Medical Center, Israel
| |
Collapse
|
36
|
Maternal warmth buffers the effects of low early-life socioeconomic status on pro-inflammatory signaling in adulthood. Mol Psychiatry 2011; 16:729-37. [PMID: 20479762 PMCID: PMC2925055 DOI: 10.1038/mp.2010.53] [Citation(s) in RCA: 222] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The notion that family support may buffer individuals under adversity from poor outcomes has been theorized to have important implications for mental and physical health, but little is known about the biological mechanisms that explain these links. We hypothesized that adults who grew up in low socioeconomic status (SES) households but who experienced high levels of maternal warmth would be protected from the pro-inflammatory states typically associated with low SES. A total of 53 healthy adults (aged 25-40 years) low in SES early in life were assessed on markers of immune activation and systemic inflammation. Genome-wide transcriptional profiling also was conducted. Low early-life SES individuals who had mothers, who expressed high warmth toward them, exhibited less Toll-like receptor-stimulated production of interleukin 6, and reduced bioinformatic indications of pro-inflammatory transcription factor activity (NF-κB) and immune activating transcription factor activity (AP-1) compared to those who were low in SES early in life but experienced low maternal warmth. To the extent that such effects are causal, they suggest the possibility that the detrimental immunologic effects of low early-life SES environments may be partly diminished through supportive family climates.
Collapse
|
37
|
Steptoe A. Psychosocial biomarker research: integrating social, emotional and economic factors into population studies of aging and health. Soc Cogn Affect Neurosci 2011; 6:226-33. [PMID: 20360352 PMCID: PMC3073386 DOI: 10.1093/scan/nsq032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 03/08/2010] [Indexed: 01/20/2023] Open
Abstract
There are complex reciprocal relationships between health and social, emotional and economic factors in aging populations. Social and affective neurosciences are rapidly developing an understanding of the mechanisms underlying these phenomena using sophisticated behavioural, neuroimaging and psychophysiological methods. These techniques are often complex and expensive, so are generally used in relatively small selected samples rather than in large-scale cohort studies. However, an understanding of the significance of these processes in health and well-being depends on integrating findings from social and affective neuroscience into population-level studies. The aim of this article is to describe how a population perspective on the determinants of health and well-being in old age articulates with the agenda of social, affective and economic neuroscience, particularly through the application of psychosocial biomarker research. Social and affective neuroscience and epidemiological approaches provide complementary research strategies for understanding the mechanisms linking social, emotional and economic factors with health risk. This will be illustrated primarily from findings from two studies conducted at University College London, the Whitehall II Study and the English Longitudinal Study of Ageing.
Collapse
Affiliation(s)
- Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| |
Collapse
|
38
|
|
39
|
Phelan CH, Love GD, Ryff CD, Brown RL, Heidrich SM. Psychosocial predictors of changing sleep patterns in aging women: a multiple pathway approach. Psychol Aging 2010; 25:858-66. [PMID: 20731498 PMCID: PMC3780608 DOI: 10.1037/a0019622] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The authors of this investigation sought to examine changes in the sleep quality of older women over time and to determine whether dimensions of psychological well-being, health (subjective health and number of illnesses), and psychological distress (depression and anxiety) predict these changes. A secondary analysis was conducted with a longitudinal sample of aging women (Kwan, Love, Ryff, & Essex, 2003). Of 518 community-dwelling older women in the parent study, 115 women (baseline M age = 67 years, SD = 7.18) with data at baseline, 8 years, and 10 years were used for this investigation. Participants completed self-administered questionnaires and participated in in-home interviews and observations. Growth curve modeling was used to examine the overall linear trajectories of sleep quality. Growth mixture modeling was used to examine whether there were different patterns of change in sleep quality over time and to examine baseline predictors of each pattern. Sleep quality declined over time but not for all women. Two distinctly different sleep patterns emerged: good but declining sleep quality and disrupted sleep quality. Higher psychological well-being (positive relations with others, environmental mastery, personal growth, purpose in life, and self-acceptance), fewer illnesses, and lower depression scores at baseline predicted reduced odds for membership in the disrupted sleep group. Future research is needed to examine whether interventions focused on maintaining or enhancing psychological well-being could minimize later life declines in sleep quality.
Collapse
Affiliation(s)
- Cynthia H Phelan
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA.
| | | | | | | | | |
Collapse
|