With age comes responsibility: changes in stigma for boys/men with bulimia nervosa

PURPOSE

Bulimia nervosa has a strong developmental component and affects men and women. However, the risk in men is unique in that it often includes other comorbid mental illnesses (depression, substance use) and may be exacerbated by longer delays between diagnoses and treatment relative to women. Furthermore, men may not be getting the treatment needed to successfully cope. Attribution theory was used as a theoretical lens to examine stigma towards boys/men with bulimia nervosa. The goal of the current study was to investigate this stigma across a developmental trajectory (from ages 12 to 24) to explore if/when stigma onset (causal responsibility) and stigma offset (coping responsibility) move between a parent and child.

METHODS

Undergraduate students (n = 360) were randomly assigned to read a vignette describing a boy/man of varying ages (12, 15, 18, 21, and 24) with bulimia nervosa and then complete stigma ratings for both the boy/man as well as his mother and father.

RESULTS

As hypothesized, the younger boy was rated as less responsible for onset and less to blame relative to the older man. Contrary to hypotheses, ratings of parents did not show any age-related differences in stigma. Also as hypothesized, mothers were rated as more responsible for onset and offset relative to fathers.

CONCLUSIONS

Findings highlight the developmental component of the stigma as it pertains to the boy/man but suggest the associative stigma for the parents might not change over time, suggesting multiple avenues for research and stigma reduction efforts as they apply to boys/men.

LEVEL OF EVIDENCE

Level I: Evidence obtained from: at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.

The Role of Sexual Orientation in the Associations Between Religiousness and Hypertension

This study assessed the cross-sectional associations between organizational religious activity (ORA), intrinsic religiosity (IR), and hypertension in a US nationally representative sample. Data were from Wave IV of the National Longitudinal Study of Adolescent to Adult Health, collected in 2008. The sample (N = 5115, M_age = 28.96 years, 54% female) was divided into three sexual orientation categories: heterosexual, mostly heterosexual, and sexual minority. Dependent variables were systolic and diastolic blood pressure and binary cut-scores of clinical hypertension. ORA and IR were independent variables, with sexual orientation as the moderator. Multivariable analyses revealed greater ORA was associated with increased blood pressure (BP)/hypertension for the sexual minority group. There was a trend in the heterosexual group where ORA was associated with decreased BP. Generally, ORA was not associated with BP/hypertension in the mostly heterosexual group. There were no significant effects for IR. Future research should continue to examine the complex ways ORA and IR are associated with health based on sexual orientation and use longitudinal methodology to examine how ORA may impact BP/hypertension across the lifespan.

Complex assessment of relationship quality within dyads

Higher quality relationships have been linked to improved outcomes; however, the measurement of relationship quality often ignores its complexity and the possibility of co-occurring positivity and negativity across different contexts. The goal of this study is to test the added benefit of including multiple dimensions, contexts, and perspectives of relationship quality from both individuals in predicting marital functioning. The Social Relationships Index assessed positive and negative dimensions of relationship quality under neutral, positive, and support-seeking contexts for 183 heterosexual married couples. Models showed that the inclusion of multiple dimensions of relationship quality across all three contexts improved prediction of marital functioning for both women and men. The use of multidimensional multicontextual relationship quality assessments is highly recommended.

Motivation for Physical Activity among U.S. Adolescents: A Self-Determination Theory Perspective

BACKGROUND

Promoting adolescent physical activity is crucial as this marks a time when physical activity rates decline.

PURPOSE

This study examined motivation for physical activity from a self-determination theory (SDT) perspective in a large sample of adolescents in the USA across three settings: in school, out of school, and on weekends.

METHODS

Participants (N = 1,661) were adolescents from the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating study. Participants had a mean age of 14.47 (standard deviation = 1.61) and were 50.2% female. In this national sample balanced to match the U.S. population on several key demographics, 64.2% were non-Hispanic White. Analyses included three linear regression models in which estimated weekly minutes of moderate-to-vigorous physical activity (MVPA) in school, out of school, and on weekends were entered as dependent variables. Five forms of motivation (intrinsic, integrated, identified, introjected, and external) were entered simultaneously as independent variables. Age, body mass index, gender, and race/ethnicity were also included as covariates.

RESULTS

All models were significant. For MVPA in school, external regulation, introjected regulation, identified regulation, and intrinsic motivation were positively associated with MVPA. For MVPA out of school, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation were positively associated with MVPA. For MVPA on weekends, integrated regulation, and intrinsic motivation were positively associated with MVPA.

CONCLUSIONS

The relationship between motivation and MVPA varies across settings. These findings have important implications for motivating adolescents to engage in physical activity and may inform future interventions aimed at increasing physical activity.

Strength of belief: Religious commitment, knowledge, and HPV vaccination adherence

OBJECTIVE

Human papillomavirus (HPV) infects millions of men and women annually and is a substantial contributing factor in many cancers including oral, penile, anal, and cervical. Vaccination can reduce risk but adherence nationwide and, particularly in highly religious states, is suboptimal. Religious principles of abstinence before marriage and total fidelity following marriage may create a belief of protection through adherence to religious guidelines. However, while one partner may remain monogamous, one cannot be assured of their partner's behavior both before and after marriage. These misconceptions may create a barrier to religious youth's adherence to vaccine recommendations.

METHODS

We sampled single young adults, age 18 to 25 years, from a Christian university classified as highly religious and a university not categorized as highly religious.

RESULTS

Highly religious young adults demonstrated low knowledge of HPV and HPV vaccination. High religious beliefs were associated with lower HPV vaccination adherence.

CONCLUSIONS

Understanding the role religious beliefs have on vaccine adherence can help in the creation of campaigns that specifically address these issues. Campaigns to increase vaccination should address misconceptions of religious youth's feelings of imperviousness to sexually transmitted diseases.

Beyond the Dichotomy: Modernizing Stigma Categorization

Even though our knowledge of the cause of disease and disability has grown, stigma still exists. Weiner, Perry, and Magnusson's seminal study on attributions of stigma has been cited over 500 times since its publication in 1988. The current research sought to replicate and expand this literature in two studies. We used the 10 stigmas from the original study and we added six more (representing common psychological and physical stigmas). In the first study, we examined the classification of stigmas using cluster analysis. We found that instead of dichotomizing stigmas into either psychological or physical, attributions of controllability and stability together resulted in four distinct clusters. Although these were mostly consistent with past literature, the fourth cluster included both psychological and physical stigmas and was rated as moderately controllable and moderately stable. In the second study, we examined how information about responsibility shifts causal attributions, emotional responses, and helping behaviors. Information that an individual was responsible for their stigma led to greater attributions of controllability, less positive emotions, and less help compared to information that an individual was not responsible. More interestingly, the no-information control condition was similar to the responsibility information condition for stigmas that fell into the controllable clusters whereas the control condition was similar to the not responsible information condition for stigmas that fell into the uncontrollable clusters. While parsimony is valued, the psychological/physical dichotomy is not nuanced enough to fully capture the variation in stigmas, which in turn has implications for future research on stigma reduction.

Stereotypes, Emotions, and Behaviors Toward Lesbians, Gay Men, Bisexual Women, and Bisexual Men

The utility of the Stereotype Content Model (Fiske, Cuddy, Glick, & Xu, 2002) and the Behaviors from Intergroup Affect and Stereotypes map (Cuddy, Fiske, & Glick, 2007) were examined in the context of heterosexuals' attitudes toward sexual minorities. Heterosexual adults completed a survey measuring stereotypes, emotions, and behavioral tendencies toward lesbians, gay men, bisexual women, and bisexual men. Stereotype content differed across groups and showed "gendered" and "valenced" effects on emotions and behavioral tendencies. Competence predicted behaviors for men, whereas warmth and competence predicted behaviors for women, and, for the most part, more was better. Admiration and contempt mediated most of these relationships across most subgroups, but pity and envy played smaller roles for some subgroups. Across all groups, competence played a more predictive role than warmth.

Psychological and Physical Health Correlates of Coping in Minority Adolescents

In the current study the relations between coping and psychological/physical health in a sample of minority adolescents was investigated. Participants ( n = 182) were all low-income, first-generation college-bound students from historically underrepresented groups. For Mexican-Americans, positive reinterpretation, focusing and venting emotions, instrumental social support, active coping, religious, restraint, emotional support, acceptance and planning forms of coping were all associated with positive psychological and physical health; for African-Americans, coping methods were notsignificantly associated with psychological or physical health; for Asian-Americans, positive reinterpretation, active coping, religious coping, restraint, acceptance and planning forms of coping were associated with onlypsychological health. Culturalspecific (rather than genderspecific) socialization is identified as a potential explanation of these results.

Testing the Invariance of the National Health and Nutrition Examination Survey's Sexual Behavior Questionnaire Across Gender, Ethnicity/Race, and Generation

Federal and state policies are based on data from surveys that examine sexual-related cognitions and behaviors through self-reports of attitudes and actions. No study has yet examined their factorial invariance--specifically, whether the relationship between items assessing sexual behavior and their underlying construct differ depending on gender, ethnicity/race, or age. This study examined the factor structure of four items from the sexual behavior questionnaire part of the National Health and Nutrition Examination Survey (NHANES). As NHANES provided different versions of the survey per gender, invariance was tested across gender to determine whether subsequent tests across ethnicity/race and generation could be done across gender. Items were not invariant across gender groups so data files for women and men were not collapsed. Across ethnicity/race for both genders, and across generation for women, items were configurally invariant, and exhibited metric invariance across Latino/Latina and Black participants for both genders. Across generation for men, the configural invariance model could not be identified so the baseline models were examined. The four item one factor model fit well for the Millennial and GenerationX groups but was a poor fit for the baby boomer and silent generation groups, suggesting that gender moderated the invariance across generation. Thus, comparisons between ethnic/racial and generational groups should not be made between the genders or even within gender. Findings highlight the need for programs and interventions that promote a more inclusive definition of "having had sex."

College student mental health and quality of workplace relationships

OBJECTIVE

The goal of this study was to examine the effect of quality of workplace relationships on the mental health of employed undergraduates, with work-related variables as a potential mechanism.

PARTICIPANTS

Participants were 170 employed students (76% female, average age = 19.9) recruited in March 2011. Most worked part-time and had been at their jobs over a year.

METHODS

Students were recruited from an undergraduate introductory psychology course and completed online surveys about the quality of workplace relationships, mental health (ie, somatic stress symptoms, depression, anxiety, and life satisfaction), and work-related variables (ie, job satisfaction, support, turnover and burnout).

RESULTS

Students who reported having workplace relationships with co-occurring positivity and negativity had worse self-reported mental health outcomes than students reporting having wholly positive relationships. The relationship between workplace relationship quality and mental health was mediated by negative work-related variables.

CONCLUSIONS

Workplace relationships-even in part-time employment settings-influence college students' mental health.

Subliminal activation of social ties moderates cardiovascular reactivity during acute stress

OBJECTIVE

The quality of one's personal relationships has been reliably linked to important physical health outcomes, perhaps through the mechanism of physiological stress responses. Most studies of this mechanism have focused on whether more conscious interpersonal transactions influence cardiovascular reactivity. However, whether such relationships can be automatically activated in memory to influence physiological processes has not been determined. The primary aims of this study were to examine whether subliminal activation of relationships could influence health-relevant physiological processes and to examine this question in the context of a more general relationship model that incorporates both positive and negative dimensions.

METHOD

We randomly assigned participants to be subliminally primed with existing relationships that varied in their underlying positivity and negativity (i.e., indifferent, supportive, aversive, ambivalent). They then performed acute psychological stressors while cardiovascular and self-report measures were assessed.

RESULTS

Priming negative relationships was associated with greater threat, lower feelings of control, and higher diastolic blood pressure reactivity during stress. Moreover, priming relationships high in positivity and negativity (ambivalent ties) was associated with the highest heart rate reactivity and greatest respiratory sinus arrhythmia decreases during stress. Exploratory analyses during the priming task itself suggested that the effects of negative primes on biological measures were prevalent across tasks, whereas the links to ambivalent ties was specific to the subsequent stressor task.

CONCLUSIONS

These data highlight novel mechanisms by which social ties may impact cardiovascular health, and further suggest the importance of incorporating both positivity and negativity in the study of relationships and physical health.

Social support and the reactivity hypothesis: conceptual issues in examining the efficacy of received support during acute psychological stress

Social support has been reliably related to better physical health outcomes. One influential model suggests that social support is related to lower cardiovascular disease mortality because it reduces the potentially deleterious consequences of cardiovascular reactivity during acute stress. However, received support and perceived support are separable constructs and epidemiological research suggests variability in links between received support and health. This is important because most social support and acute laboratory stress studies are essentially based on the receipt of support. In this paper, we focus on the conceptualization of received support and its implications for understanding links to support laboratory reactivity paradigms. This analysis highlights the role of theoretically important task, recipient, and provider categories of factors that moderate the effectiveness of received support, as well as the need to examine links between naturalistic perceptions of support and cardiovascular reactivity during stress.

Dispositional hope and the propensity to cope: a daily diary assessment of minority adolescents

The authors examined the predictive ability of dispositional hope components (pathways, agency) in explaining minority adolescents' consistent use of daily coping strategies. Using daily diary methodology, 126 low socioeconomic status minority participants completed a multidimensional measure of dispositional hope and reported on subsequent stressful events that they experienced and the coping strategies that they employed over the course of a 5-day period. Multilevel modeling analyses revealed that hope-pathways was uniquely and positively related to direct problem solving, planning, positive thinking, religious coping, distracting action, and overall coping use. Hope-agency was uniquely and positively associated with instrumental support for actions. Discussion focuses on the role of hope as a protective factor for minority adolescents experiencing stress, and particularly the unique predictive ability of each hope component.

Evidence for the Factorial Validity of the Dispositional Hope Scale

Confirmatory factor analyses were employed to test the factorial validity and structure of the Dispositional Hope Scale (DHS; Snyder et al., 1991 ). In a large multiethnic sample (n = 1031), a two-factor representation of the DHS fit the data significantly better than a one-factor model. These findings suggest that the DHS is better conceptualized as being composed of Agency and Pathways components and not as a unidimensional representation of general hope. Multigroup analyses revealed that the factor pattern coefficients were invariant across gender and ethnic groups, respectively, thus establishing metric invariance of the DHS. However, item intercepts, item uniqueness terms, the factor variance for the Agency factor, and both the Agency and Pathways latent factor means statistically differed as a function of gender (but not ethnicity). These findings suggest that while the two-factor structure of the DHS is relatively stable and robust, both measurement and substantive differences as a function of gender must be accounted for.

Coping with Prostate Cancer: A Meta-Analytic Review

The present meta-analytic review assessed the relations between coping categories and indices of adjustment in men with prostate cancer. Relevant methodological and statistical information was extracted from 33 target studies (n = 3,133 men with prostate cancer). Men with prostate cancer who used approach, problem-focused, and emotion-focused coping were healthier both psychologically and physically, although the effect sizes for problem-focused coping and emotion-focused coping were more modest. For approach coping these effect sizes were particularly strong for measures of self-esteem, positive affect, depression, and anxiety. Conversely, men with prostate cancer who used avoidance coping experienced heightened negative psychological adjustment and physical health, and particularly for measures of positive mood and physical functioning. The findings of this study suggest that active approaches to coping with prostate cancer are beneficial psychologically, physically, and are positively associated with a return to pre-cancer activities.

Developing and validating a stress appraisal measure for minority adolescents

Although there are a number of measures designed to assess the cognitive appraisal of stress in adult populations, currently there are no measures that are specifically designed to assess this important construct in adolescents. To overcome this limitation, the factorial validity and dimensionality of a dispositional measure of stress appraisal was examined in the current study. Using a multiethnic adolescent sample, both exploratory and confirmatory factor analyses resulted in a three-factor representation of appraisal. The three factors included two primary appraisal dimensions (Threat and Challenge) and one secondary appraisal dimension (Resources). This three-factor model, however, is inconsistent with four- and six-factor models found previously in adult samples. Thus, these findings suggest that the cognitive appraisals made by adolescents are less complex or differentiated than those of adults. Moreover, these findings suggest that dispositional measures are relevant for adolescent samples and should be incorporated into stress and coping paradigms.

On the dimensionality of the stress-related growth scale: one, three, or seven factors?

We examined the factorial validity and dimensionality of the Stress-Related Growth Scale (SRGS; Park, Cohen, & Murch, 1996) using a large multiethnic sample (n = 1,070). Exploratory and confirmatory factor analyses suggested that a multidimensional representation of the SRGS fit better than a unidimensional representation. Specifically, we cross-validated both a 3-factor model and a 7-factor model using confirmatory factor analysis and were shown to be invariant across gender and ethnic groups. The 3-factor model was represented by global dimensions of growth that included rational/mature thinking, affective/emotional growth, and religious/spiritual growth. We replicated the 7-factor model of Armeli, Gunthert, and Cohen (2001) and it represented more specific components of growth such as Self-Understanding and Treatment of Others. However, some factors of the 7-factor model had questionable internal consistency and were strongly intercorrelated, suggesting redundancy. The findings support the notion that the factor structure of both the original 1-factor and revised 7-factor models are unstable and that the 3-factor model developed in this research has more reliable psychometric properties and structure.