Journal of Behavioral Medicine

Experiencing growth after the diagnosis of a life threatening illness is commonly reported among people living with HIV (PLWH). The links between benefit finding and better adjustment in PLWH have been identified, but it is less clear whether these links vary by ethnicity. Minority stress theory suggests that individuals from minority populations may have unique stress experiences, which can have negative health implications but may also provide opportunity for growth. We hypothesized that the association between benefit finding and psychological adjustment would be stronger for Black (n = 80) than White (n = 87) PLWH. Contrary to predictions, the relationship between benefit finding and better adjustment was significant for White but not Black PLWH. Post-hoc analyses suggested that sexual orientation played role in this relationship. The relationship between benefit finding and psychological adjustment may be complex for Black PLWH, or they may achieve adjustment using other resources.

Religiousness has been observed to have a beneficial relationship with blood pressure, however, specific aspects of religiousness that interact with physiological mechanisms to influence this relationship are not known. This study explored laboratory cardiovascular reactivity (blood pressure, heart rate) to psychological stress among middle aged community dwelling individuals grouped by religious motivation (Intrinsic, Pro-religious, Non-religious). Measures of personality, cynical hostility, aggression, sense of coherence, and compassion were administered. Results indicated that the Pro-religious group demonstrated dampened reactivity compared to the other research groups. However, the Pro-religious also demonstrated a less positive psychological profile (e.g., greater cynicism, aggression, and neuroticism; less compassion and sense of coherence) and poorer self-reported health compared with the Intrinsic group and behavioral observations demonstrated that the Pro-religious were unreliable in keeping appointments and appeared rushed during the experiment. These findings indicate a complicated interface between personality, coping, and religious motivation in response to stressors and emphasize the need for naturalistic and longitudinal investigations of individuals who vary in terms of religious motivation.

We explored the effects of uncontrollability and subjective helplessness (SHL) on perceived pain intensity (PPI) in 64 healthy men randomly assigned to groups receiving controllable (C) or uncontrollable (UC) painful electric skin stimuli. SHL (d = 1.43), perceived unpleasantness (d = 1.03), and PPI (d = 0.58) were more pronounced in the UC group than in the C group. Multiple regression and bootstrap analyses for testing mediation showed a direct relationship between stressor uncontrollability and PPI (r = 0.28; P < .05), which disappeared when adjusted for the SHL increase (β = 0.49, P < .001). SHL changes were associated with objective uncontrollability (r = 0.59, P < .001). PPI and unpleasantness were positively correlated (r = 0.37, P < .01). The study suggests that the effect of objective controllability on pain intensity ratings is mediated mainly by ratings of SHL.

Untreated perinatal depression and anxiety are significant public health problems that disproportionately affect ethno-racial minorities. The purpose of this study was to examine the effectiveness of a coordinated perinatal mental health care model, focusing on socially-disadvantaged, ethno-racial minority women, with an intersectional-feminist perspective. The treatment model was grounded in intersectionality theory with the aim of addressing complex social vulnerability factors in the context of perinatal mental health treatment. Participants were 67 perinatal women (64% African American or Hispanic/Latina) referred by medical providers at an urban teaching hospital. Results demonstrated high treatment engagement and effectiveness, with 65.9% of participants demonstrating reliable improvement in symptoms. Moreover, African American and Hispanic/Latina patients had similar treatment outcomes compared to White patients, despite facing greater socio-economic disadvantages. Findings indicate that the treatment model may be a promising approach to reducing perinatal mental health disparities. Strengths and limitations of the study are discussed within the intersectionality framework.

This study examined symptom judgments made by medical students of hypothetical chronic low back pain patients. Eight vignettes were varied as to the pain intensity reported by the hypothetical patient (low vs. moderate vs. high vs. very high) and the availability of medical evidence supportive of the pain report (present vs. absent). Ninety-five subjects read vignettes and made judgments of patient emotional distress, pain intensity, and pain-related disability. Subjects significantly discounted pain level when intensity was high but slightly augmented pain level when intensity was low. Judgments of pain and disability were higher for patients for whom medical evidence was present compared to those for whom it was absent. The results support and extend previous research on the effects of situational and patient variables on observer pain judgments. Future research should examine the influence of these biasing variables on the assessment and treatment of chronic pain patients.

This study examined the impact of fear control and danger control messages on intentions to perform health behaviors. It was hypothesized that persons high in masculinity would be more influenced by messages that address fear than messages that exclusively focus on the efficacy of the behavior (danger control). To test this proposition, 172 participants were classified into high and low masculinity groups according to their scores on the Bem Sex Role Inventory, and randomly assigned fear reducing or danger control messages either encouraging detection behavior (skin cancer self-examination) or promotion behavior (sunscreen usage). Highly masculine participants demonstrated greater behavioral intentions and more positive attitudes about the behavior when exposed to a fear-reducing message. The results suggest that it is possible to motivate adaptive health behavior even when a person is engaging in fear control.

The Common-Sense Model of Self-Regulation (the “Common-Sense Model”, CSM) is a widely used theoretical framework that explicates the processes by which patients become aware of a health threat, navigate affective responses to the threat, formulate perceptions of the threat and potential treatment actions, create action plans for addressing the threat, and integrate continuous feedback on action plan efficacy and threat-progression. A description of key aspects of the CSM’s history—over 50 years of research and theoretical development—makes clear the model’s dynamic underpinnings, characteristics, and assumptions. The current article provides this historical narrative and uses that narrative to highlight dynamic aspects of the model that are often not evaluated or utilized in contemporary CSM-based research. We provide suggestions for research advances that can more fully utilize these dynamic aspects of the CSM and have the potential to further advance the CSM’s contribution to medical practice and patients’ self-management of illness.

In addition to higher morbidity and mortality, Black adults have reported lower self-rated health than White adults. The purpose of this study was to evaluate the diminishing difference in self-rated health between races from 1972 to 2008. Data from 37,936 participants over a 36-year span of the General Social Survey were used to evaluate the effects of race and time on self-rated health. Results confirmed that Black adults reported significantly worse health than White adults. Overall health was rated slightly better across both groups as time went on ( $$ \hat{\beta } $$  = .002, P < .0005). However, this increase in health ratings has slowed, even reversing with a decline in health ratings as of late ( $$ \hat{\beta } $$  = −.014, P = .001). Significant interactions between race and time indicated that the racial difference on this self-rated health measure has changed over time. The rate of change in the difference has slowed over time ( $$ \hat{\beta } $$  = −.010, P = .021), suggesting that the reduction in the racial difference in self-rated health may be decelerating.

Yoga is an ancient mind–body practice that is increasingly recognized to have health benefits in a variety of clinical and non-clinical conditions. This systematic review summarizes the findings of randomized controlled trials examining the effects of yoga on immune system functioning which is imperative to justify its application in the clinic. Fifteen RCTs were eligible for the review. Even though the existing evidence is not entirely consistent, a general pattern emerged suggesting that yoga can downregulate pro-inflammatory markers. In particular, the qualitative evaluation of RCTs revealed decreases in IL-1beta, as well as indications for reductions in IL-6 and TNF-alpha. These results imply that yoga may be implemented as a complementary intervention for populations at risk or already suffering from diseases with an inflammatory component. Beyond this, yoga practice may exert further beneficial effects by enhancing cell-mediated and mucosal immunity. It is hypothesized that longer time spans of yoga practice are required to achieve consistent effects especially on circulating inflammatory markers. Overall, this field of investigation is still young, hence the current body of evidence is small and for most immune parameters, more research is required to draw distinct conclusions.

Although drop out rates in weight management interventions are high, little is known about characteristics of people dropping out at different time points during such interventions. This study aims to examine characteristics of early and late drop outs during a self-management intervention aimed at weight control, hypothesizing that changes in psychological characteristics during active intervention would differentiate drop outs from completers. Participants’ (N = 167) socio-demographics and personality traits were measured via self-report at baseline, as well as their behavioral and psychological outcomes before and during the intervention. No baseline differences were found between early drop outs and initial completers. As expected, late drop outs were characterized by a different change pattern in self-efficacy during the initial phase compared to completers. Few differences in other characteristics were found. Changes in self-efficacy during active intervention are relevant for understanding drop out in weight management interventions.