Sonia Suchday

Discovering how urban poverty and violence affect health: development and validation of a Neighborhood Stress Index

Health problems of the urban poor have been attributed to psychosocial effects of environmental stress. Testing such models requires an ability to measure neighborhood characteristics that make life stressful. The City Stress Inventory (CSI) uses self-report to assess perceived neighborhood disorder and exposure to violence. Data from an interracial sample of urban adolescents show the CSI to be internally consistent, stable, and correlated with census indices of social disadvantage. Validity for stress research is indicated by correlations with trait depression, anger, hostility, self-esteem, and mood changes during a debate with an unfamiliar peer. The CSI can be completed by persons with an 8th-grade education.

Measuring Stress Resilience and Coping in Vulnerable Youth: The Social Competence Interview

A brief interview to measure stress coping capabilities was developed and tested in 4 samples of African American and White adolescents in low-income neighborhoods of 2 large U.S. cities. The Social Competence Interview (SCI) is a 10-min social stressor that assesses physiological and social-emotional responses to a recurring real-life problem. A new behavioral coding system using audiotapes permits reliable and valid assessment of components of social competence, including Interpersonal Skills (expressiveness, empathy), Goal-Oriented Strivings in coping (self defense, social acceptance, competitiveness, stimulation-pleasure, approval, self improvement), and Social Impact (high vs. low affiliation/control). High SCI expressiveness and self-defensive striving create a critical-aggressive social impact, which is correlated with increased hostility and anger.

A Pilot Study Measuring the Impact of Yoga on the Trait of Mindfulness

BACKGROUND The current study examined whether yoga would increase levels of mindfulness in a healthy population. METHOD Forty-six participants were randomly assigned to an 8-week yoga intervention group or a wait-list control group. Mindfulness was assessed pre and post yoga, using the Freiburg Mindfulness Inventory (FMI). RESULTS Results indicate that the yoga group experienced a significant increase in Overall mindfulness, and in three mindfulness subscales; Attention to the present moment, Accepting and open attitudes toward experience, and Insightful understanding (p < .01). The control group experienced a significant increase in overall mindfulness (p < .02) and insightful understanding (p < .01). Findings suggest that a yoga intervention may be a viable method for increasing levels of trait mindfulness in a healthy population, potentially implicating yoga as a preventive method for the later development of negative emotional mood states (i.e. anxiety and depression). The control group also experienced moderate elevations of mindfulness at the second assessment.

Application of the Competency Model to Clinical Health Psychology

In response to the growing emphasis on defining professional competence within applied psychology (e.g.,clinical, neuropsychology, counseling, school), in 2007 American Psychological Association Division 38(Health Psychology) sponsored a summit meeting with a specific focus on revisiting the standards of graduatecurricula and training in clinical health psychology. Using the cube model of core competency domains ofprofessional psychology as a framework, summit participants were charged with identifying the foundationaland functional competencies expected of a well-trained, entry-level clinical health psychologist. As a productof these discussions, the present article is presented as an initial effort to identify the competencies and beginthe discussion in clinical health psychology. As such it is likely to be of interest to a wide audience, includingclinical training programs with an existing or planned emphasis in clinical health psychology, practitionersinterested in acquiring the competencies required to practice as a clinical health psychologist, and studentsevaluating potential graduate and postgraduate training options in clinical health psychology.Keywords: clinical, health psychology, competencyC

A qualitative assessment of barriers and facilitators to achieving behavior goals among obese inner-city adolescents in a weight management program

Purpose The purpose of this study was (1) to examine the reasons for managing weight, (2) to investigate the barriers and facilitators to achieving behavior goals, and (3) to assess how a behavior coach affects the goalsetting process of obese innercity adolescents in a weight management program. Methods Obese adolescents participating in a pilot study assessing the role of a behavior coach on successful weight management (n = 18) were interviewed to identify barriers and facilitators to reaching behavior goals. Data were analyzed using descriptive statistics and the constant comparative method of qualitative analysis. Results In the rationale for weight control, adolescent girls and boys reported a desire to improve physical appearance and physical conditioning, respectively. Barriers to reaching physical activity goals among girls included unsafe neighborhoods and a negative body image. Maintaining unrealistic behavior and weight goals hindered satisfaction with behavior change and weight loss in both genders. Overall, coaching provided support that helped the obese teens feel more successful in the goalsetting process and address issues related to their disruptive environments. Conclusions Diabetes educators can include a behavior coach as part of a weight management program to help teens set behavior goals and overcome barriers to reaching behavior goals.

Relationship Between Forgiveness and Psychological and Physiological Indices in Cardiac Patients

BackgroundResearch suggests that forgiveness is associated with better psychological and physical health and in particular cardiovascular functioning. Despite these findings, most forgiveness studies involve healthy participants.PurposeThe current study assessed the psychological and physiological correlates of forgiveness in individuals with coronary artery disease (CAD).MethodSelf-reported forgiveness, perceived stress, anxiety, and depression, and physiological data, including triglycerides, total cholesterol, high- (HDL) and low-density lipoprotein (LDL) cholesterol, were obtained from 85 hospitalized CAD patients.ResultsHigher levels of forgiveness were associated with lower levels of anxiety (p < 0.05), depression (p < 0.01), and perceived stress (p < 0.005) as well as lower total cholesterol to HDL and LDL to HDL ratios (both at p < 0.05) after controlling for age and gender. The psychological indices did not mediate the relationship between forgiveness and cholesterol ratios.ConclusionsResults suggest that the psychological correlates of forgiveness are similar in cardiac patients and healthy individuals. Further, among cardiac patients, forgiveness may be associated with reduced risk for future cardiovascular events.

Anger in Young Black and White Workers: Effects of Job Control, Dissatisfaction, and Support

This cross-sectional study tested the hypothesis that characteristics of work that contribute to job strain also increase anger in young service-sector workers. A new measure of anger directed at coworkers, supervisors, and customers was regressed on job strain indices (job control, coworker and supervisor support, dissatisfaction) in models that controlled for dispositional negative affect and work status. Results in a sample of 230 young Black and White men and women revealed that low levels of job control and social support, and high levels of job dissatisfaction, were independently associated with increased work-related anger. Moreover, social support moderated the impact of low job control on anger directed at coworkers. Findings indicate that anger experienced at work may be an early marker of job stress, which has been prospectively related to cardiovascular disease.

Social Support and Networks: Cardiovascular Responses Following Recall on Immigration Stress Among Chinese Americans

Abstract Social support has been shown to act as a buffer for cardiovascular responses to stress. However, little is known about how social support and networks are related to cardiovascular responses to immigration stress recall. The current study evaluated the impact of structural and functional support on cardiovascular reaction following immigrant stress recall provocation as well as the moderation effect of interdependent self-construal among first-generation Chinese immigrants. One hundred fifty Chinese immigrants were recruited in the New York Chinatown area. Participants completed questionnaires assessing their levels of social support and networks, and interdependent self-construal. Following adaptation, participants recalled a recent post-immigration stress-provoking situation. Cardiovascular measures were taken during adaptation, stressor task, and recovery period. Hierarchical multiple regression analysis was performed. Social network size and type, as well as perceived emotional support were positively predictive of systolic blood pressure (SBP) reactivity changes. Instrumental support seeking was a positive predictor of SBP and diastolic blood pressure (DBP) reactivity. The moderation effect between instrumental support seeking and interdependent self-construal were significantly predictive of DBP reactivity and recovery, suggesting that perceptions about themselves in relation to others is a crucial factor for determining whether support seeking is beneficial or not. Social support was not a direct buffer on cardiovascular responses to stress among Chinese immigrants. Chinese values of interdependence and collectivism may partly explain the disconfirming results. Still, when interdependent self-construal was taken into account, Chinese immigrants who had less interdependent self-construal, but solicited more instrumental support, had faster adaptation to stress over the long term.

Religion, spirituality, globalization reflected in life beliefs among urban Asian Indian youth.

Spiritual and religious values/beliefs/practices are entwined in all aspects of functioning among people in the Indian subcontinent. The current study focuses on understanding the spiritual zeitgeist entwined in the mundane day-to-day functioning (e.g., lifestyles/beliefs) of young people in India. Undergraduates at Xavier’s College in Mumbai, India (N = 361; Mage = 19 years; Females = 67.7%; Hindus = 41.1%, Christian/Catholic = 38.7%; Other = 20.02%) completed a 30-item survey of lifestyle beliefs. Exploratory factor analysis indicated the presence of 6 factors: collectivism, materialism, collectivism, religiosity, personal agency, spirituality/wellness, and karma. These factors can be conceptualized as karma (action/word/deed–rewards/punishments) and dharma (duty/responsibility/righteousness) and tradition and nontradition (materialism/ambition). Data from a subgroup of the sample (n = 153; female: 92%; Hindu: 42.5%; Christian: 44.4%; Other: 9.8%; Muslim: 3.3%) indicated some overlap in traditional Indian values and Western conceptualizations of spiritual and religious well-being; specifically, collectivism (r = .22), religiosity (r = .75), and karma (r = .21) positively correlated and materialism (r = −.24) negatively correlated with religious well-being; religiosity (r = .16) and collectivism (r = .17) were positively correlated with existential well-being. Interdependent self-construal correlated with collectivism (r = .46), religiosity (r = .23), and karma (r = .22). Identification with being Indian correlated with collectivism (r = .23), religiosity (r = .29), spirituality/wellness (r = .16), and karma (r = .23) indicating a strong association between self-perceived Indianness and traditional values. This sample represents young people in Mumbai, which is at the forefront of globalization. Overall data indicate resilience of traditional Indian values and beliefs (e.g., karma/dharma) and change as reflected in endorsement of materialism, ambition, and self. These preliminary data provide avenues for further exploring the influences of forces of globalization on resilient traditional Indian values.

The Effects of Meditation and Yoga on Cardiovascular Disease

Cardiovascular disease is a chronic illness with physiological, behavioral, and psychosocial components implicated in the etiology and course of the disorder. Given its multifaceted nature, management of cardiovascular disease needs to be multidimensional and include attention to all risk factors. Research has indicated that modification of one risk factor (e.g., diet) does not lead to automatic benefits to other risk factors (e.g., exercise) (Prochaska, Nigg, Spring, Velicer, & Prochaska, 2010). Hence, attention needs to be focused simultaneously on both physiological and psychological components. For example, medical regimens need to be augmented by lifestyle changes that include diet and exercise. Psychosocial variables such as depression, hostility, and stress also play a key role in morbidity and mortality associated with cardiovascular disease and need to be independently managed. An explicit focus on techniques that involve concurrent physiological and psychological interventions makes mind-body therapies effective and appealing in dealing with cardiovascular disorders. Mind-body medicine is the most widely used domain of complementary and alternative medicine among the US population for treatment of medical conditions (NIH, 2004). Examples of mind-body medicine include meditation, yoga, relaxation, visual imagery, biofeedback, qigong, cognitive-behavioral therapies, support groups, tai chi, and spirituality. This chapter will focus on the most widely studied and used interventions, specifically, yoga and meditation.