Examining the Role of Psychosocial Stressors in Hypertension

Despite advances in medicine and preventive strategies, fewer than 1 in 5 people with hypertension have the problem under control. This could partly be due to gaps in fully elucidating the etiology of hypertension. Genetics and conventional lifestyle risk factors, such as the lack of exercise, unhealthy diet, excess salt intake, and alcohol consumption, do not fully explain the pathogenesis of hypertension. Thus, it is necessary to revisit other suggested risk factors that have not been paid due attention. One such factor is psychosocial stress. This paper explores the evidence for the association of psychosocial stressors with hypertension and shows that robust evidence supports the role of a chronic stressful environment at work or in marriage, low socioeconomic status, lack of social support, depression, anxiety, post-traumatic stress, childhood psychological trauma, and racial discrimination in the development or progression of hypertension. Furthermore, the potential pathophysiological mechanisms that link psychosocial stress to hypertension are explained to address the ambiguity in this area and set the stage for further research.     

Examining Mechanisms Underlying Fear-Control in the Extended Parallel Process Model

This investigation sought to advance the extended parallel process model in important ways by testing associations among the strengths of efficacy and threat appeals with fear as well as two outcomes of fear-control processing, psychological reactance and message minimization. Within the context of print ads admonishing against noise-induced hearing loss (NIHL) and the fictitious Trepidosis virus, partial support was found for the additive model with no support for the multiplicative model. High efficacy appeals mitigated freedom threat perceptions across both contexts. Fear was positively associated with both freedom threat perceptions within the NIHL context and favorable attitudes for both NIHL and Trepidosis virus contexts. In line with psychological reactance theory, a freedom threat was positively associated with psychological reactance. Reactance, in turn, was positively associated with message minimization. The models supported reactance preceding message minimization across both message contexts. Both the theoretical and practical implications are discussed with an emphasis on future research opportunities within the fear-appeal literature.     

The Impact of Acculturative Stress and Daily Hassles on Pre-adolescent Psychological Adjustment: Examining Anxiety Symptoms

Acculturative stress in relation to anxiety symptoms has not been examined empirically in young Hispanic populations. The present study, conducted with 138 pre-adolescent Hispanic youngsters, investigated this relationship. The findings suggested that acculturative stress was related to physiological, concentration, and worrisome symptoms of anxiety. After decomposing acculturative stress, it became evident that perceived discrimination accounted for a large proportion of the variance in the relationship between acculturative stress and anxiety. Immigration-related stress was mostly associated with worry symptoms. Finally, total daily hassles were an independent predictor of concentration and physiological anxiety symptoms. Implications for prevention interventions and future research are discussed.     

Illuminating the Role of Vitamin A in Skin Innate Immunity and the Skin Microbiome: A Narrative Review

Vitamin A is a fat-soluble vitamin that plays an important role in skin immunity. Deficiencies in Vitamin A have been linked to impaired immune response and increased susceptibility to skin infections and inflammatory skin disease. This narrative review summarizes recent primary evidence that elucidates the role of vitamin A and its derivatives on innate immune regulators through mechanisms that promote skin immunity and sustain the skin microbiome.     

Examining the General Practitioner's Role in Health Education: A Critical Review

Calnan M. Examining the general practitioner's role in healtheducation: a critical review. Family Practice1988; 5: 217–223. Recent international and national policy documents have placedgreat emphasis on health promotion programmes and one of thekey figures in these programmes has been the general practitionerand the primary health care team. This review, drawing mainlyon evidence from the United Kingdom, critically reviews therole of the general practitioner in health promotion and diseaseprevention. The first part of the paper examines the assumptionsin contemporary policy and outlines alternative roles for thegeneral practitioner in health education. The second part focuseson the social organization of the doctor-patient relationshipand its influence on health education, specifically examiningthe structure of the doctor-patient relationship, the uncertaintiesin scientific health knowledge and the lay perspective on health.     

Loneliness and Shyness in Adolescent Problematic Internet Users: The Role of Social Anxiety

Background

Davis’ (Comput Hum Behav 17:187–195, 2001) cognitive–behavioral model of problematic Internet use (PIU) proposed and theorized that certain psychopathological characteristics present within an individual, predispose him to PIU.

Objective

This study extended Davis’ model in hypothesizing that social anxiety mediates in a multi-mediational relationship between two psychological variables (loneliness and shyness) and PIU.

Methods

681 adolescents (49.6 % male, 50.4 % female) between 14 and 15 years of age, participated in this study. Data were collected using the Social Reticence Scale, the revised UCLA Loneliness scale, Social Anxiety Scale for Adolescents and the Generalized PIU scale. The statistical approach of structural equation modeling was used to analyse the data collected.

Results

Results obtained revealed support for a model in which social anxiety fully mediated the relationship between the psychological variables of shyness and loneliness and PIU.

Conclusions

In addition to supporting Davis’ (Comput Hum Behav 17:187–195, 2001) theoretical model that certain psychopathological characteristics present within an individual predisposes him to PIU, this study extended the theory in demonstrating that social anxiety mediates between loneliness/shyness and PIU.     

Child Presence During Psychologically Aggressive Interparental Conflict: Implications for Internalizing and Externalizing Behavior

Based on a sample of parents (N = 148) of 4‐ to 7‐year‐olds (N = 74, M = 5.76 years), this study adapted a widely used, self‐report measure of couples' dyadic conflict behavior to include reports of couples' conflict behavior in the child's presence (triadic conflict) to examine their additive and interactive associations with child maladjustment. Significant interaction effects suggested that higher levels of triadic psychologically aggressive conflict were associated with higher levels of child externalizing (b = .134, p = .024) and internalizing (b = .189, p < .001) problems, but only if levels of dyadic psychological aggression were average or higher. When levels of couples' dyadic psychological aggression were low, levels of child presence did not relate to child behavior. Predictors of triadic psychological aggression included parental involvement (b = .266, p = .003), parent–child functioning (b = ?.288, p = .042), and marital adjustment (b = ?.346, p < .001).     

The Foreign Language Anxiety in a Medical Office Scale: Developing and Validating a Measurement Tool for Spanish-Speaking Individuals

Communication research has been hindered by a lack of validated measures for Latino populations. To develop and validate a foreign language anxiety in a medical office scale (the Foreign Language Anxiety in a Medical Office Scale [FLAMOS]), the authors conducted a survey of low income, primarily Spanish-speaking Latinos (N = 100). The scale factored into a unidimensional construct and showed high reliability (α = .92). The Foreign Language Anxiety in a Medical Office Scale also demonstrated convergent and divergent validity compared with other communication anxiety scales (Personal Report of Communication Apprehension–24, Communication Anxiety Inventory, and Recipient Apprehension Test), and predictive validity for acculturation measures (the Short Acculturation Scale for Hispanics). The Foreign Language Anxiety in a Medical Office Scale provides a validated measure for researchers and may help to explain Latino health care communication barriers.     

Anxiety and Depression in Older Adolescents With Long-Standing Asthma: The Role of Illness Uncertainty

This study examined the differential contribution of illness uncertainty to self-reported anxiety and depression in a sample of older adolescents with childhood-onset asthma. Fifty-six individuals completed measures of illness uncertainty, anxiety, and depression. In addition, objective assessments of illness severity were obtained via a semistructured interview and pulmonary function test. Results revealed that illness uncertainty contributed significant variance to anxiety after statistically controlling the effects of demographic and disease parameters and depressive symptomatology; illness uncertainty did not contribute significant variance to depression. Findings suggest that interventions should target illness uncertainty and psychosocial education, as well as early identification and treatment of anxiety in this understudied population.     

Examining the Presence of Problem Gambling Awareness Messages on College Counseling Center Websites

College students are more at-risk for developing a gambling problem than the general adult U.S. population. Information behavior and information seeking theories, as well as empirical evidence, indicate that one resource that may provide guidance for students dealing with this issue is the college counseling center website (CCW). This study addressed the presence and nature of problem gambling messages on CCWs. As a random sample, 203 CCWs were selected to assess how frequently they provided any information about problem gambling, as well as the specific types of communications CCWs offered on this topic. Results showed that CCWs rarely included any messages about problem gambling. Specifically, only 15% of all CCWs contained information about problem gambling. Furthermore, messages about problem gambling were presented significantly less frequently than messages involving alcohol abuse, substance abuse, depression, anxiety/stress, and psychological struggles with food. Given the prevalence of problem gambling among college students, as well as the value that college students place on information provided on CCWs, it is important that these sites offer more information concerning this issue.     

Racial Differences in Behavioral Inpatient Diagnosis: Examining the Mechanisms using the 2004 Florida Inpatient Discharge Data

This study used the 2004 Florida Inpatient Discharge Data to examine the existence and the underlying mechanisms of the African American (AA)/white differences in behavioral inpatient diagnosis across a diverse patient population. Findings suggest that discharges of AA patients in Florida were at least twice as likely to have received a primary psychotic vs. affective or substance-related diagnosis, and this held true after between-hospital differences were controlled for. Furthermore, AA (vs. white) race was associated with a ratio of 3.3 in the population rate of hospitalization with a primary psychotic diagnosis, as compared to a ratio of 0.8 and 0.7 for affective and substance-related disorders, respectively. These findings demonstrated the wide existence of racial differences in behavioral inpatient diagnosis and the important role of clinician diagnostic behaviors as opposed to systems-level factors (such as racial differences in access to care and care-seeking behaviors) in leading to observed differences.     

Examining Associations Between Narcissism,Behavior Problems,and Anxiety in Non-Referred Adolescents

The present study examined associations between narcissism (total, adaptive, and maladaptive), self-esteem, and externalizing and internalizing problems in 157 non-referred adolescents (aged 14 to 18). Consistent with previous research, narcissism was positively associated with self-reported delinquency, overt aggression, and relational aggression. Maladaptive narcissism showed unique positive associations with aggression and delinquency variables, while adaptive narcissism showed unique negative associations with anxiety symptoms. In general, self-esteem was negatively related to internalizing and externalizing problems. An interaction effect was observed for self-esteem and narcissism in predicting overt aggression. Specifically, at high levels of self-esteem narcissism was significantly associated with overt aggression, whereas it was not at low levels of self-esteem. The current results add to the growing body of research on the role of narcissism in the development of adjustment problems in youth.     

Examining the Role of Implementation Quality in School-Based Prevention Using the PATHS Curriculum

In order for empirically validated school-based prevention programs to go to scale, it is important to understand the processes underlying program dissemination. Data collected in effectiveness trials, especially those measuring the quality of program implementation and administrative support, are valuable in explicating important factors influencing implementation. This study describes findings regarding quality of implementation in a recent effectiveness trial conducted in a high-risk, American urban community. This delinquency prevention trial is a locally owned intervention, which used the Promoting Alternative THinking Skills Curriculum as its major program component. The intervention involved 350 first graders in 6 inner-city public schools. Three schools implemented the intervention and the other 3 were comparison schools from the same school district. Although intervention effects were not found for all the intervention schools, the intervention was effective in improving children's emotional competence and reducing their aggression in schools which effectively supported the intervention. This study, utilizing data from the 3 intervention schools (13 classrooms and 164 students), suggested that 2 factors contributed to the success of the intervention: (a) adequate support from school principals and (b) high degree of classroom implementation by teachers. These findings are discussed in light of the theory-driven models in program evaluation that emphasized the importance of the multiple factors influencing the implementation of school-based interventions.     

The Role of Pain-Related Anxiety Reduction in the Outcome of Multidisciplinary Treatment for Chronic Low Back Pain: Preliminary Results

The success of multidisciplinary treatments for chronic pain in helping patients suffer less and function better is well documented. However, this success has occurred despite a lack of understanding of the process of change that produces positive outcomes. The purpose of this study was to investigate the role of pain-related anxiety reduction in the outcome of treatment for chronic pain. Seventy-nine persons with chronic pain completed measures of pain, pain-related interference with activity, affective distress, general daily activity, and pain-related anxiety at admission and immediately following a 3-week multidisciplinary treatment program focusing on functional restoration. Patients significantly improved on all outcome measures. Reductions in pain-related anxiety predicted improved functioning on each measure. Additional analyses showed that change in pain-related anxiety remained a significant predictor of outcome independent of change in depression.     

Examining Young Recreational Sportswomen's Intentions to Engage in Sun-Protective Behavior: The Role of Group and Image Norms

Researchers examined the sun-protective intentions and behavior of young, Caucasian, Australian sportswomen aged between 17 and 35 years (N?=?100). The study adopted a 2 x 2 experimental design, comparing group norms (supportive vs. non-supportive) and image norms (tanned vs. pale) related to sun protection and taking into account group identification with friends and peers in the sport. While no significant findings emerged involving image norms, regression analyses revealed a significant two-way interaction for group norm x identification on recreational sportswomen's intentions to engage in sun protection in the next fortnight. Participants identifying strongly with their group had stronger intentions to engage in sun protection when exposed to a norm reflecting fellow recreational sportswomen engaging in sun-protective actions in comparison to those exposed to a non-supportive group. In addition, while prior intentions to engage in sun protection were not significantly related to sun-protection behavior, post-manipulation intentions after exposure to the sun-protective information that was provided were significantly related to follow-up behavior. Overall, the findings supported the importance of group-based social influences, rather than tanned media images, on sun-protective decisions among young recreational sportswomen and provided a targeted source for intervention strategies encouraging sun safety among this at-risk group for repeated sun exposure.     

Putting the Fear Back Again (and Within Individuals): Revisiting the Role of Fear in Persuasion

The overwhelming majority of fear appeal research came from the between-individuals approach and yielded consistent evidence for a linear fear–persuasion relationship. A recent review suggested that the within-individuals approach might be more appropriate. Studies that measured fear at multiple time points have consistently revealed a curvilinear association between fear and persuasion predicted by the drive model. A Web-based experiment (N = 454) using tobacco warning labels was conducted to replicate the inverted-U shape curvilinear relationship between fear and persuasion, and to revisit the role of fear in fear appeal theories. Results showed that the inverted-U fear curve positively predicted persuasion and reduced maladaptive responses, and that the linear trajectory of fear positively predicted maladaptive responses and failure of persuasion.     

Cooking as a Health Behavior: Examining the Role of Cooking Classes in a Weight Loss Intervention

Americans are cooking fewer meals at home and eating more convenience foods prepared elsewhere. Cooking at home is associated with higher quality diets, while a reduction in cooking may be associated with increases in obesity and risk factors for chronic disease. The aims of this study were to examine cooking as an intervention for weight control in overweight and obese adults, and whether such an intervention increases participants’ food agency and diet quality. Overweight and obese adults were randomized into one of two intervention conditions: active or demonstration. Both conditions received the same 24-week behavioral weight loss intervention, and bi-weekly cooking classes. The active condition prepared a weekly meal during a hands-on lesson, while the demonstration condition observed a chef prepare the same meal. The active condition lost significantly more weight at six months compared with the demonstration condition (7.3% vs. 4.5%). Both conditions saw significant improvements in food agency scores and Healthy Eating Index scores, though no significant differences were noted between groups. The addition of active cooking to a weight management intervention may improve weight loss outcomes, though benefits in diet quality and cooking behaviors may also be seen with the addition of a demonstration-only cooking intervention.