Paula G. Williams

Adolescent Health Psychology

In this article, a biopsychosocial model of adolescent development is used as an organizing framework for a review of primary, secondary, and tertiary prevention research with adolescent populations. During adolescence many critical health behaviors emerge, affecting future disease outcomes in adulthood. In addition, most of the predominant causes of morbidity and mortality in adolescence are unique to this period of development, indicating that health-focused interventions must be tailored specifically to adolescents. Moreover, it is during adolescence that lifelong patterns of self-management of and adjustment to chronic health conditions are established. Thus, an increased focus on adolescence in health psychology research is important both to improve the health of adolescents per se and to optimize health trajectories into adulthood.

Coping processes as mediators of the relationship between hardiness and health.

Hardiness has been hypothesized to moderate the impact of stress on health by influencing coping responses, but little attention has been focused upon these associations. This study examined the relationship among hardiness, coping, and illness while attending to recent criticisms of the hardiness literature including the potential overlap with neuroticism, whether hardiness is a unitary construct, and the predominant use of male samples. Hardiness was found to be positively related to adaptive coping variables and negatively related to maladaptive coping variables. Problem-focused, support-seeking, and avoidant coping were found to mediate the hardiness-illness relationship. Although these hardiness-coping relationships were partially independent of the influence of neuroticism, the relationship of both coping and hardiness with self-reported illness appeared to result from the common influence of neuroticism. Consistent with previous research, the commitment and control components correlated most consistently with coping variables, and predicted hardiness effects were most consistently demonstrated for males.

Individual Differences in Executive Functioning: Implications for Stress Regulation

BackgroundExecutive functioning (EF) refers to the set of neurocognitive processes that facilitate novel problem solving, modification of behavior in response to environmental changes, planning and generating strategies for complex actions, and ability to override pre-potent behavioral and emotional responses to engage in goal-directed behavior.PurposeTo provide an overview of research on individual differences in EF and examine the extent to which these individual differences confer risk and resilience for poor stress regulation.ResultsReview of the literature suggests that individual differences in EF are evident at multiple levels of analysis including genotype, endophenotype (e.g., performance on cognitive tasks), and phenotype (e.g., temperament and personality). These individual differences are associated with differential stress exposure, reactivity, recovery, and restorative processes.ConclusionsA theoretical framework that includes individual differences in EF will inform behavioral medicine research on stress risk and resilience.

The Psychopathology of Self-Assessed Health: A Cognitive Approach to Health Anxiety and Hypochondriasis

This paper reviews the relevant cognitive research on health anxiety and hypochondriasis, as well as research examining temperament/personality and social developmental factors relevant to health and illness cognition and associated negative emotional states. A cognitive developmental model is proposed which integrates individual difference variables, selective attention/cognitive factors, and social learning processes that may serve as vulnerability and maintenance factors in the etiology of health anxiety and hypochondriasis. Future directions for the study of cognition and hypochondriasis are suggested.

Individual Differences in Self-Assessed Health: An Information-Processing Investigation of Health and Illness Cognition

In 2 studies, the relation between measures of self-assessed health (SAH) and automatic processing of health-relevant information was investigated. In Study 1, 84 male and 86 female undergraduate students completed a modified Stroop task. Results indicated that participants with poorer SAH showed enhanced interference effects for illness versus non-illness words. In Study 2, 27 male and 30 female undergraduate students completed a self-referent encoding task. Results offered a conceptual replication and extension of Study 1 by confirming the specificity of the relation between SAH measures and automatic processing of health (vs. negative or positive general trait) information. These studies provide evidence that individual differences in SAH are reflected in schematic processing of health-relevant information.

Executive Functioning and Health: Introduction to the Special Series

Advances in the fields of neuropsychology and neuroscience have fueled a renewed interest in the association between brain functioning and health. This burgeoning activity is clearly due in part to the development and refinement of cognitive assessment techniques and brain imaging technology. Of particular relevance to health psychology and behavioral medicine has been recent research on the set of brain functions collectively termed “executive” (alternately termed executive functioning, executive cognitive functioning, or executive functions). This issue of Annals of Behavioral Medicine presents a series of papers that illustrate how research on central topics in health psychology and behavioral medicine may be informed by considering the role of executive functioning (EF), including maintenance and change of health behavior, stress regulation, developmental trajectories of aging and mortality, and management of chronic illness.

Cellular aging and restorative processes: subjective sleep quality and duration moderate the association between age and telomere length in a sample of middle-aged and older adults.

STUDY OBJECTIVES To examine whether subjective sleep quality and sleep duration moderate the association between age and telomere length (TL). DESIGN Participants completed a demographic and sleep quality questionnaire, followed by a blood draw. SETTING Social Neuroscience Laboratory. PARTICIPANTS One hundred fifty-four middle-aged to older adults (age 45-77 y) participated. Participants were excluded if they were on immunosuppressive treatment and/or had a disease with a clear immunologic (e.g., cancer) component. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and TL was determined using peripheral blood mononuclear cells (PBMCs). There was a significant first-order negative association between age and TL. Age was also negatively associated with the self-reported sleep quality item and sleep duration component of the PSQI. A significant age × self-reported sleep quality interaction revealed that age was more strongly related to TL among poor sleepers, and that good sleep quality attenuated the association between age and TL. Moreover, adequate subjective sleep duration among older adults (i.e. greater than 7 h per night) was associated with TL comparable to that in middle-aged adults, whereas sleep duration was unrelated to TL for the middle-aged adults in our study. CONCLUSIONS The current study provides evidence for an association between sleep quality, sleep duration, and cellular aging. Among older adults, better subjective sleep quality was associated with the extent of cellular aging, suggesting that sleep duration and sleep quality may be added to a growing list of modifiable behaviors associated with the adverse effects of aging.

Examination of the Neuroticism-Symptom Reporting Relationship in Individuals with Type 2 Diabetes:

The current study utilized a within-subject, experience sampling methodology (ESM) to examine the relationship between neuroticism (N) and physical symptom reports. Individuals with type 2 diabetes monitored diabetes-related symptoms, rated negative and positive affect (NA and PA), estimated their blood glucose (BG) levels, and tested their actual BG levels with a glucometer four times per day for 7 days. Multilevel modeling analyses indicated that N, NA, and PA were related to reported symptom frequency. Neuroticism moderated the relation between PA and symptom reports: Lower PA was more strongly related to symptom reports among high-N individuals. In addition, there was evidence that symptoms mediated the relationship between N and state NA. Finally, N was related to overestimation of BG, beyond that accounted for by state NA. Results are discussed with respect to potential effects of N on the processing of negative self-relevant information and on self-regulatory behavior in health contexts.

Instrumental Activities of Daily Living Among Community-Dwelling Older Adults: Personality Associations With Self-Report, Performance, and Awareness of Functional Difficulties

Self-reports of the ability to engage in instrumental activities of daily living (IADLs) among older adults are known to be related to personality traits. However, self-reports are sometimes discrepant with performance-based IADL assessments, and little is known about personality associations with objective functionality or with poor insight about functional deficits. This study examined the NEO Personality Inventory-Revised profiles associated with (a) self-report of functional problems, (b) functional errors evidenced on performance-based IADL assessment, and (c) discrepancies between self-report and performance. Participants were 65 community-dwelling individuals ranging in age from 60 to 87 years. The results showed that self-report of IADL problems are associated with higher neuroticism and lower conscientiousness, actual IADL difficulties with higher neuroticism and lower agreeableness and openness to experience, underreporting of problems with higher conscientiousness, and overreporting of problems with higher extraversion and neuroticism. These relationships were partly mediated by age, education, and cognitive status. When unique personality associations with self-report and performance were examined, neuroticism and agreeableness, respectively, emerged as the strongest predictors.

Effects of tonic and phasic respiratory sinus arrhythmia on affective stress responses.

Adaptive affective responses in the face of environmental challenges require flexible physiological responding. The present study examined the extent to which tonic respiratory sinus arrhythmia (RSA)-a putative marker of regulatory capacity-moderated the association between stress-related changes in RSA (i.e., phasic RSA) and concurrent changes in affect. Ninety-eight healthy, young adults completed ratings of affect during a resting baseline and following the recall of a recent stressor. Tonic RSA moderated the association of phasic RSA with stress-related change in positive affect (PA), such that change in RSA had a positive association with PA for individuals with higher tonic RSA and a negative association for those with lower tonic RSA. Examination of specific aspects of PA indicated that phasic RSA was positively associated with changes in ratings of attentive engagement among individuals with higher tonic RSA. These findings inform our understanding of phasic RSA and support the notion that flexible parasympathetic nervous system functioning is an important component of adaptive stress regulation.