Funded Proposals--2008

 

 

Susan A. David, Department of Psychology, Yale University

Title:  Practitioner and Patient Emotional Skills: Their Role in Promoting Positive Health Behaviors

Abstract:  Successful public healthcare strategies rely on complex environmental-individual interactions.  Interventions that target lifestyle changes such as ceasing tobacco use, decreasing obesity, improving nutrition and increasing physical activity, rely on people's ability to self-regulate their behaviors in ways that are consistent with these outcomes.  Traditionally, psychological investigations of people's ability to modify their physical health have focused on behavioral and cognitive variables.  However, even when the necessary cognitive attributes (e.g., knowledge, attitudes, and beliefs) and physical abilities to positively affect health behaviors are present, people often do not take actions that are concordant with their health goals.  Practitioners too may inadvertently hinder the success of patients in the attainment of health objectives.  One factor that has been neglected both in the public health and psychology research is the role of emotions in health.  An integrated longitudinal design will sample from a national population of 2000 healthcare practitioners and their community patients who are seeking to make positive health related changes in the areas of weight management, nutrition, and physical activity.  The proposed research investigates how the emotional reasoning and processing skills of practitioners and their patients impact on the attainment of these health outcomes.  The evidence suggests that these skills may be developed, making this a promising line of inquiry.  The research also investigates the capacity of an emotion processing intervention to facilitate patients' attainment of health goals.

 

 

Elissa Epel, Department of Psychiatry, University of California-San Francisco

Title:  How Does Chronic Stress Cause Obesity?  A Longitudinal Analysis of Potential Lifestyle and Biochemical Mediators and Moderators  

Abstract:  People under chronic stress, such as caregivers, have dramatically increased risk of morbidity and mortality, and this may be due in part to stress eating and weight gain.  Increases in visceral fat play an important role in chronic disease.  Paradoxically, however, chronic stress has bidirectional effects on weight, causing weight loss in some and, more commonly, weight gain in others (Kivimaki et al., 2006; Brunner, 2007).  It is essential to understand what makes some people gain visceral fat during chronic stress, as well as factors that are protective against weight gain.  To date, no studies have focused on understanding mechanisms for weight changes during chronic stress.  Our primary aim is to better understand how chronic stress causes changes in adiposity over a one-year period.  To address this question, we will recruit 100 older women (50 to 75 years), half of whom are high stress ('dementia caregivers') and half low stress ('controls' matched on BMI at baseline).  We will measure adiposity (using DEXA, BMI, WHR), dietary intake and eating patterns, physical activity and sleep (using actigraphy), and stress resistance (active coping style and stress reactivity-cortisol response to a standardized laboratory stressor), and changes in adiposity one year later.  We hypothesize that those who gain visceral fat will have higher fat intake, dysregulated eating, and impaired sleep.  Those who maintain or lose weight will show greater stress resistance.  Understanding the interactive role of behavioral and biochemical factors in predicting weight change will offer novel insight into how stress affects adiposity.

 

 

Lauri A. Jensen-Campbell, Department of Psychology, University of Texas-Arlington

Title:  Peer Victimization and Its Influence on Physiology and Health

Abstract:  Estimates of American children who report being repeatedly victimized by their peers range from 10 to 30% (e.g., Nansel et al., 2001).  Children who have poor peer relations suffer from both psychological and physical health problems and these effects are often persistent well into adulthood.  As such, being victimized by peers is a serious public health problem and current theory and research needs to better understand why adolescent peer victimization is associated with negative health consequences.  Approximately 300 6th - 8th grade adolescents will complete questionnaires regarding their peer relationships, friendship networks, levels of victimization, and health (Phase 1).  In Phase 2, 50 highly victimized adolescents (+1 SD) as well as 50 adolescents who do not report being victimized (-1 SD) will come into the lab twice with a parent.  Adolescents will collect basal cortisol samples four times a day for a 2-day period.  They will then return to the lab and complete a social stress task while cortisol reactivity samples will be collected.  Adolescents experiencing peer victimization should have more health problems, higher basal cortisol levels, and stronger cortisol stress responses to instances of social stress.  Furthermore, adolescents with higher basal cortisol levels and reactivity responses should have poorer physical and psychological health outcomes.  Finally, it is anticipated that having social support from friends will attenuate the neuroendocrine response associated with social stress and poorer health outcomes.  Results should have implications for promoting adjustment and health across the lifespan.