Stephanie A. Hooker

Exposure to Acute Stress is Associated with Attenuated Sweet Taste

This study examined the effects of stress on taste perception. Participants (N = 38; 21 women) completed two laboratory sessions: one stress (public speaking, math, and cold pressor) and one control rest session. The taste perception test was conducted at the end of each session and included rating the intensity and pleasantness of sweet, salty, sour, and savory solutions at suprathreshold concentrations. Cardiovascular, hormonal, and mood measures were collected throughout the sessions. Participants showed the expected changes in cardiovascular, hormonal, and mood measures in response to stress. Reported intensity of the sweet solution was significantly lower on the stress day than on the rest day. Cortisol level poststress predicted reduced intensity of salt and sour, suggesting that stress-related changes in adrenocortical activity were related to reduced taste intensity. Results indicate that acute stress may alter taste perception, and ongoing research investigates the extent to which these changes mediate effects of stress on appetite.

Religiousness/spirituality, cardiovascular disease, and cancer: Cultural integration for health research and intervention.

OBJECTIVE Recently, behavioral scientists have developed greater interest in understanding the relations between religiousness and spirituality (R/S) and health. Our objectives were to (a) provide an overview of the R/S and health literature specific to cardiovascular disease (CVD) and cancer, (b) discuss the importance of religious culture considerations to behavioral medicine research, (c) suggest methodological changes to advance this research toward greater depth of understanding, and (d) begin discussion on clinically appropriate ways to integrate R/S into treatment. METHOD Individual studies and meta-analyses on the relations of R/S with CVD and cancer were reviewed along with articles on the importance of culture to understanding R/S phenomena. RESULTS Trends in the literature suggest that R/S predicts reductions in all-cause and CVD-related but not cancer mortality. R/S also shows relations with cardiovascular morbidity, and various dimensions of R/S show relations with cancer risk factors and well-being in cancer patients. Investigators have progressively studied more specific dimensions of R/S but have largely failed to consider them within religious cultural contexts. This context is essential for a deeper understanding of R/S and health relations and has profound methodological implications for future studies. CONCLUSIONS R/S and health research is expanding; yet, the field needs more programmatic research and greater theoretical organization. We propose that consideration of R/S variables within their religious culture will provide structure for greater integrative understanding to move the field forward. This understanding is imperative if R/S is to be appropriately integrated into culturally sensitive clinical interventions.

Purpose in life is associated with physical activity measured by accelerometer

Previous research has shown that purpose in life, the belief that one’s life is meaningful and goal-directed, is associated with greater engagement in self-reported physical activity. The purpose of this study was to examine the relationship between purpose in life and accelerometer-measured physical activity. Community volunteers (N = 104) completed measures of purpose in life and potential confounds and wore accelerometers for three consecutive days. Purpose in life was positively associated with objectively measured movement, moderate to vigorous physical activity, and with self-reported activity. These relationships were largely unchanged after controlling for potential confounds. These results suggest that purpose in life is a reliable correlate of physical activity.

Circulating leptin levels are associated with increased craving to smoke in abstinent smokers

The adipocyte hormone leptin regulates satiety and energy expenditure. Recent evidence suggests that leptin is associated with increased craving for alcohol and with shorter length of abstinence during alcohol treatment. This study examined leptins associations with craving for cigarettes and smoking relapse among smokers interested in cessation. Participants (32 smokers; 14 women) attended a laboratory session 24h following their designated quit day where circulating leptin levels and craving for smoking were assessed. Other measures of withdrawal symptoms, affect, physical symptoms, as well as neuroendocrine and cardiovascular measures were collected before and after performing two stress tasks (public speaking and cognitive tasks). High circulating leptin levels were associated with increased craving, withdrawal symptoms, negative affect, physical symptoms, and reduced positive affect. Circulating leptin levels were not related to cardiovascular and neuroendocrine measures, responses to acute stressors, or to smoking relapse. These results indicate that circulating leptin is a promising biological marker of craving for smoking and warrant further investigation of the links between appetite regulation and nicotine dependence.

The Impact of Relationship Quality on Health-Related Outcomes in Heart Failure Patients and Informal Family Caregivers: An Integrative Review.

Background:Relationships can have positive and negative impacts on health and well-being. Dyadic relationships between heart failure (HF) patients and their informal family caregivers may affect both patient and caregiver outcomes. Objective:The aim of this study is to synthesize the literature to date on the associations between HF patient-caregiver relationship quality and communication and patient and caregiver health outcomes. Methods:An integrative review of the literature was conducted. Computerized literature searches in Medline, PsycInfo, CINAHL, Web of Science, and EMBASE yielded 13 articles of HF patients and caregivers. Included articles were reviewed and double-coded by 2 independent coders. Results:Included articles measured relationship quality or aspects of communication within an HF patient-caregiver dyad and used both cross-sectional and longitudinal designs. Results of the longest prospective study suggested that better relationship quality between HF patients and their informal family caregivers was related to a reduced risk for mortality in patients. Results of 11 of the 12 other studies were consistent to the reference study, suggesting that better relationship quality and communication were related to reduced mortality, increased health status, less distress, and lower caregiver burden. Conclusions:Relationship quality and communication seem to matter in the health and well-being of both HF patients and their informal family caregivers. More research is needed to elucidate mechanisms and to design effective relationship-focused interventions.

Family caregiving for persons with heart failure at the intersection of heart failure and palliative care: a state-of-the-science review

Many of the 23 million individuals with heart failure (HF) worldwide receive daily, unpaid support from a family member or friend. Although HF and palliative care practice guidelines stipulate that support be provided to family caregivers, the evidence base to guide care for this population has not been comprehensively assessed. In order to appraise the state-of-the-science of HF family caregiving and recommend areas for future research, the aims of this review were to summarize (1) how caregivers influence patients, (2) the consequences of HF for caregivers, and (3) interventions directed at HF caregivers. We reviewed all literature to December 2015 in PubMed and CINAHL using the search terms “heart failure” AND “caregiver.” Inclusion criteria dictated that studies report original research of HF family caregiving. Articles focused on children or instrument development or aggregated HF with other illnesses were excluded. We identified 120 studies, representing 5700 caregivers. Research on this population indicates that (1) caregiving situations vary widely with equally wide-ranging tasks for patients to help facilitate their health behaviors, psychological health and relationships, and quality of life (QoL); (2) caregivers have numerous unmet needs that fluctuate with patients’ unpredictable medical status, are felt to be ignored by the formal healthcare system, and can lead to distress, burden, and reduced QoL; and (3) relatively few interventions have been developed and tested that effectively support HF family caregivers. We provide recommendations to progress the science forward in each of these areas that moves beyond descriptive work to intervention development and clinical trials testing.

An Interpersonal Approach to Religiousness and Spirituality: Implications for Health and Well‐Being

The interpersonal tradition (Horowitz & Strack, 2011) provides a rich conceptual and methodological framework for theory-driven research on mechanisms linking religiousness and spirituality (R/S) with health and well-being. In three studies, we illustrate this approach to R/S. In Studies 1 and 2, undergraduates completed various self-report measures of R/S, interpersonal style, and other aspects of interpersonal functioning. In Study 3, a community sample completed a wide variety of R/S measures and a measure of interpersonal style. Many, but not all, aspects of religiousness (e.g., overall religiousness, intrinsic religiousness) were associated with a warm interpersonal style, and most aspects and measures of spirituality were associated with a warm and somewhat dominant style. Spirituality and related constructs (i.e., gratitude, compassion) were associated with interpersonal goals that emphasize positive relationships with others, and with beneficial interpersonal outcomes (i.e., higher social support, less loneliness, and less conflict). However, some aspects of R/S (e.g., extrinsic religiousness, belief in a punishing God) were associated with a hostile interpersonal style. R/S have interpersonal correlates that may enhance or undermine health and emotional adjustment. This interpersonal perspective could help clarify why some aspects of religiousness and spirituality are beneficial and others are not.

Feasibility and Acceptability of a Collaborative Care Intervention To Improve Symptoms and Quality of Life in Chronic Heart Failure: Mixed Methods Pilot Trial

BACKGROUND People with chronic heart failure (HF) suffer from numerous symptoms that worsen quality of life. The CASA (Collaborative Care to Alleviate Symptoms and Adjust to Illness) intervention was designed to improve symptoms and quality of life by integrating palliative and psychosocial care into chronic care. OBJECTIVE Our aim was to determine the feasibility and acceptability of CASA and identify necessary improvements. METHODS We conducted a prospective mixed-methods pilot trial. The CASA intervention included (1) nurse phone visits involving structured symptom assessments and guidelines to alleviate breathlessness, fatigue, pain, or depression; (2) structured phone counseling targeting adjustment to illness and depression if present; and (3) weekly team meetings with a palliative care specialist, cardiologist, and primary care physician focused on medical recommendations to primary care providers (PCPs, physician or nurse practioners) to improve symptoms. Study subjects were outpatients with chronic HF from a Veterans Affairs hospital (n=15) and a university hospital (n=2). Measurements included feasibility (cohort retention rate, medical recommendation implementation rate, missing data, quality of care) and acceptability (an end-of-study semi-structured participant interview). RESULTS Participants were male with a median age of 63 years. One withdrew early and there were <5% missing data. Overall, 85% of 87 collaborative care team medical recommendations were implemented. All participants who screened positive for depression were either treated for depression or thought to not have a depressive disorder. In the qualitative interviews, patients reported a positive experience and provided several constructive critiques. CONCLUSIONS The CASA intervention was feasible based on participant enrollment, cohort retention, implementation of medical recommendations, minimal missing data, and acceptability. Several intervention changes were made based on participant feedback.

Multidimensional Assessment of Religiousness/Spirituality and Health Behaviors in College Students

Research has demonstrated a positive relation between particular religious/spiritual variables and health behaviors and outcomes. However, recent conceptualizations of religiousness/spirituality (R/S) and health acknowledge the multidimensionality of both constructs. Consequently, it is important to study these constructs in ways that allow for simultaneous consideration of their multiple dimensions and then determine relations between the latent higher order constructs formed by these analyses. The primary purpose of this study was to determine the relations between multidimensional constructions, based on multivariate analysis, of both R/S and health behaviors in first- and second-year college students, individuals who are at a time of transition. To achieve this aim, the authors used canonical correlation to determine if one or more latent R/S variables might be identified and associated with one or more latent health behavior variables. Participants were 266 first- and second-year undergraduates (61% female; M age = 18.6 years) who completed measures of R/S and health behaviors. Results indicated one significant canonical correlation relating the latent variable named Relational Personal Spirituality positively with the second latent variable, Healthy College Behavior. These findings suggest the need for multidimensional assessment and multivariate analysis of both R/S and health behaviors and support further exploration of the role of personal spirituality in promoting healthier behaviors among college students.

Harnessing centred identity transformation to reduce executive function burden for maintenance of health behaviour change: the Maintain IT model

ABSTRACT The inability to produce sustainable lifestyle modifications (e.g., physical activity, healthy diet) remains a major barrier to reducing morbidity and mortality from prevalent, preventable conditions. The objective of this paper is to present a model that builds on and extends foundational theory and research to suggest novel approaches that may help to produce lasting behaviour change. The model aims to integrate factors not typically examined together in order to elucidate potential processes underlying a shift from behaviour initiation to long-term maintenance. The central premise of the Maintain IT model builds on approaches demonstrating that in-tact executive function (EF) is critical for health behaviour initiation, for more complex behaviours beyond initiation, and in unsupportive environments and circumstances, but successful recruitment of EF is effortful and prone to error. Enduring changes are more likely if the underlying cognitive processes can become less effortful (non-conscious, automatic). The Maintain IT model posits that a centred identity transformation is one path leading to less effortful processing and facilitating successful recruitment of EF when necessary over the long term, increasing the sustainability of health behaviour change. A conceptual overview of the literature supporting the utility of this integrative model, future directions, and anticipated challenges are presented.