Claudia Trudel-Fitzgerald

Validation of a short version of the maternal behavior Q-set applied to a brief video record of mother-infant interaction.

A 25 item version of the maternal behavior Q-set (MBQS) was validated with 40 adolescent mother-infant dyads. Observations were made from 10 min play interactions when infants were 10 months old. Results show that the short MBQS is reliable (r(i)=.94), is related to assessments using the full MBQS at 6 months (r=.35), to cognitive development at 10 and 15 months (r=.48), and attachment security at 15 months (r=.34), indicating appropriate psychometric characteristics.

Taking the Tension Out of Hypertension: A Prospective Study of Psychological Well-Being and Hypertension

Background: Previous studies have shown that psychological well being is associated with reduced risk of cardiovascular disease. However, whether well being might be specifically associated with reduced risk of hypertension has not been rigorously investigated in prospective studies. Objective: This study examined the prospective association between two measures of psychological well being and incident hypertension. Methods: Participants were 6384 healthy British civil servants aged 39–63 from the Whitehall II cohort. Psychological well being (emotional vitality and optimism) and cardiovascular risk factors (demographic characteristics, health status, health behaviors, psychological ill being) were assessed during the 1991–1994 baseline. Incident hypertension was defined by clinical measures of SBP or DBP at least 140/90 mmHg, self-reported physician-diagnosed hypertension, or treatment for hypertension. Follow-up assessments of hypertension took place approximately every 3 years through 2002–2004. Cox proportional hazards regression models estimated hazard ratios. Results: There were 2304 cases of incident hypertension during the follow-up period. High versus low emotional vitality was associated with a significantly reduced risk of hypertension in an age-adjusted model (hazard ratio = 0.89; 95% confidence interval 0.80–0.98). This association was maintained after controlling for demographic characteristics and health status, but was slightly attenuated after adjusting for health behaviors and ill being. Optimism was not significantly associated with hypertension. Conclusion: High emotional vitality was associated with reduced hypertension risk; favorable health behaviors explained only part of the relationship. Associations did not differ by age, were similar for men and women, and were maintained after accounting for ill being.

The Prospective Association Between Positive Psychological Well-Being and Diabetes

OBJECTIVE Positive psychological well-being has protective associations with cardiovascular outcomes, but no studies have considered its association with diabetes. This study investigated links between well-being and incident diabetes. METHODS At study baseline (1991-1994), 7,800 middle-aged British men and women without diabetes indicated their life satisfaction, emotional vitality, and optimism. Diabetes status was determined by self-reported physician diagnosis and oral glucose tolerance test (screen detection) at baseline and through 2002-2004. Incident diabetes was defined by physician-diagnosed and screen-detected cases combined and separately. Logistic regression estimated the odds of developing diabetes controlling for relevant covariates (e.g., demographics, depressive symptoms). Models were also stratified by gender and weight status. RESULTS There were 562 combined cases of incident diabetes during follow-up (up to 13 years). Well-being was not associated with incident diabetes for combined physician-diagnosed and screen-detected cases. However, when examining the 288 physician-diagnosed cases, life satisfaction and emotional vitality were associated with up to a 15% decrease in the odds of physician-diagnosed diabetes, controlling for demographics (results were similar with other covariates). Optimism was not associated with physician-diagnosed diabetes, and no well-being indicator was associated with screen-detected diabetes. Gender and weight status were not moderators. CONCLUSIONS Life satisfaction and emotional vitality, but not optimism, were associated with reduced risk of physician-diagnosed diabetes. These findings suggest that well-being may contribute to reducing risk of a prevalent and burdensome condition, although intervention studies are needed to confirm this. It is unclear why findings differed for physician-diagnosed versus study-screened diabetes. (PsycINFO Database Record

Sleep and survival among women with breast cancer: 30 years of follow-up within the Nurses’ Health Study

Background:Breast cancer is a leading cause of cancer death in women. Sleep has been linked with mortality among cancer-free population; however, its association with survival among women with breast cancer is understudied.Methods:Breast cancer patients (N=3682) reported their average sleep duration post diagnosis. Subsamples also provided their pre-diagnosis sleep duration (n=1949) and post-diagnosis sleep difficulties (n=1353). Multivariate Cox models estimated hazard ratios (HR) and confidence intervals (CI) of all-cause, breast cancer, and non-breast cancer mortality.Results:At diagnosis, the mean age was 64.9 years and 91.7% were stage I or II. Women sleeping ⩾9 h per night post diagnosis had a strong higher risk of all-cause (multivariate HRs: MV-HR=1.37, CI=1.10–1.71), breast cancer (MV-HR=1.46, CI=1.02–2.07), and non-breast cancer mortality (MV-HR=1.34, CI=1.01–1.79), compared to women sleeping 8 h per night. Increased sleep duration post diagnosis (vs unchanged) and regular sleep difficulties (vs rare/none) were associated with a strong elevated risk of all-cause mortality (MV-HRincreased duration=1.35, CI=1.04–1.74; MV-HRregular difficulties=1.49, CI=1.02–2.19) and a moderate greater risk of breast cancer and non-breast cancer mortality.Conclusions:Various facets of sleep were associated with higher all-cause mortality risk. If replicated, these findings support evaluation of breast cancer patients’ sleep duration and difficulties to identify those at risk for poorer outcomes.

A healthy mix of emotions: underlying biological pathways linking emotions to physical health

Both positive ( e.g. , happiness) and negative ( e.g. , anxiety) emotions have been distinctively associated with health and disease outcomes. However, whether emotion-related effects are driven by specific emotions or by shared underlying features of similar co-occurring (or mixes of) emotions is still debated. This narrative review summarizes recent scientific advances regarding whether mixed emotions and emotion regulation abilities influence physical health over the lifecourse. While behavioral and biological pathways are commonly proposed to explain these relationships, biological pathways are less well understood. As a result, here we specifically focus on known and novel biological pathways. Future directions for empirical and clinical research aimed at identifying ways to lower the risk of and burden related to chronic diseases are also discussed.

Occupational class and risk of renal cell cancer

We sought to examine the association between occupational class linked to job stress and the risk of renal cell cancer. To identify potential mediators, we additionally examined whether any observed associations persisted even after controlling for the contribution of stress‐related factors (eg, smoking, hypertension, and obesity).

A Prospective Study of Marital Quality and Body Weight in Midlife.

Objective: Few studies have gone beyond studying marital status to examine effects of marital quality on body weight. This study examined the association of marital quality with weight change and incident obesity in midlife. It differentiated positive and negative components of marital quality considering overall marital quality, marital support, and marital strain. Method: Data are from 2,636 adults from the Midlife in the United States study who participated in 2 waves of data collection 10 years apart. Marital quality was self-reported. Body weight was assessed with self-reported height and weight. Generalized estimating equations examined primary associations also considering potential confounders and mediating factors including sociodemographics, baseline health conditions, and health behaviors. Results: Overall marital quality was inversely associated with weight gain (&bgr; = −0.70, 95% confidence interval [CI] [−1.38, −0.01]). Marital support was inversely related to both weight gain (&bgr; = −1.48, 95% CI [−2.80, −0.16]) and incident obesity (risk ratio = 0.79, 95% CI [0.65, 0.96]). Marital strain was not associated with either weight change or incident obesity. The association between marital support and incident obesity remained when marital strain was simultaneously included in the model. There was evidence that the associations of marital support and marital strain with incident obesity might differ by gender, and were evident only in men. Conclusion: This study shows a supportive marital relationship is associated with healthier body weight in midlife. It also indicates marital support may have effects over and beyond the mere absence of marital strain. Findings suggest the potential utility of involving spouses/partners in obesity prevention and treatment.

The relationship of perfectionism with psychological symptoms in cancer patients and the contributing role of hyperarousability and coping

Objective: Significant levels of anxiety, depression and insomnia symptoms are found in cancer patients. Perfectionism, arousability and coping have been associated with these psychological symptoms in the general population but their role among cancer patients remains to be assessed. This study examined the longitudinal relationships between perfectionism and psychological symptoms (anxiety, depression, insomnia), and the intermediate role of the arousability trait and coping strategies. Design: Participants (N = 853) completed the Multidimensional Perfectionism Scale, the Coping with Health Injuries and Problems questionnaire and the Arousal Predisposition Scale at the perioperative period (T1), and the Hospital Anxiety and Depression Scale and the Insomnia Severity Index two months later (T2). Results: Higher levels of perfectionism (T1) were correlated with greater symptoms of anxiety, depression and insomnia (T2). Moderated mediation models indicated that arousability contributed to the association of perfectionism with all symptoms, with stronger associations found in men than in women. Coping was a significant pathway between perfectionism and anxiety, with associations of a comparable magnitude across sexes. Conclusion: If these results are replicated by future longitudinal studies, they would suggest that perfectionist cancer patients are at a higher risk of experiencing psychological symptoms, partly through their hyperarousability and the coping strategies they use.

Psychological Symptoms and Subsequent Healthy Lifestyle After a Colorectal Cancer Diagnosis.

Objective: Although medical professionals recommend lifestyle changes following a colorectal cancer (CRC) diagnosis to improve outcomes, such changes are not consistently implemented. This study examines whether higher distress is associated with lower likelihood of engaging in favorable behaviors after CRC diagnosis. Method: Women from the Nurses’ Health Study prospective cohort who completed anxiety (n = 145) and depression (n = 227) symptom scales within 4 years after receiving a CRC diagnosis were included. Measures of lifestyle (diet, physical activity, alcohol, smoking, body mass index [BMI]) were queried prediagnosis, when psychological symptoms were assessed (1988 and 1992, respectively), and then every 4 years thereafter until 2010. Women were categorized according to initial psychological symptoms levels and followed through 2010 or until last follow-up completed. Results: Higher versus lower anxiety symptoms were significantly related to unhealthier lifestyle scores throughout follow-up (&bgr; = −0.25, CI [−0.44, −0.05]); however, the rate of change over time was similar across groups (pinteraction effect = 0.41). Stratified analyses hinted that higher anxiety and depression symptoms were related to increased odds of reporting a future unhealthy lifestyle within 10-years postdiagnosis. Beyond 10 years, anxiety became statistically unrelated with future lifestyle, and higher depressive symptoms were associated with lower odds of subsequently having an unhealthy lifestyle, albeit nonstatistically significant (OR = 0.35, 95% CI [0.10, 1.24], p = 0.10). Conclusions: Among women with CRC, higher anxiety and depression symptoms were associated with subsequent unhealthier lifestyle in the 10 years following diagnosis. With replication, such findings may suggest that treating psychological symptoms early in the cancer trajectory may not solely reduce psychological distress but also promote healthier lifestyle.

Do Cancer-related Beliefs Influence the Severity, Incidence, and Persistence of Psychological Symptoms?

Background: Previous studies have suggested that negative beliefs about cancer may impair patients’ psychological well-being, but only a few of these studies focused on specific psychological symptoms, and many were cross-sectional. Objective: The aim of this study was to investigate longitudinally the relationship of cancer-related cognitions with the severity, incidence, and persistence of anxiety, fear of cancer recurrence, depression, and insomnia symptoms during an 18-month period. Methods: Patients scheduled to undergo surgery for cancer (N = 962) completed a questionnaire assessing cancer-related cognitions at baseline (T1), the Hospital Anxiety and Depression Scale, the severity subscale of the Fear of Cancer Recurrence Inventory, and the Insomnia Severity Index at baseline (T1) and 2 (T2), 6 (T3), 10 (T4), 14 (T5), and 18 (T6) months later. Results: Group × time factorial analyses using mixed models revealed that participants endorsing more negative cancer-related cognitions consistently reported more severe symptoms throughout the 18-month period. Logistic regression analyses suggested that endorsing more negative cancer-related cognitions at T1 significantly increased incidence and persistence rates of clinical levels of psychological symptoms. Conclusions: These findings suggest that the endorsement of negative cancer-related beliefs at the perioperative period influences the longitudinal evolution of anxiety, fear of cancer recurrence, depression, and insomnia symptoms in the following months. Implications for Practice: These results highlight the relevance of using cognitive restructuring early during the cancer care trajectory to potentially revise erroneous beliefs about cancer and prevent the incidence and persistence of psychological disturbances over time.