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Article Summaries for May 2017 Psychosomatic Medicine, Volume 79, Issue 4

doi: 10.1097/PSY.0000000000000472

Kang et al. examined whether prioritizing self-transcendent values such as family and friends over nontranscendent values such as wealth is associated with reduced threat processing in the brain. Sedentary adults were exposed to messages encouraging physical activity, such as “A lack of activity can be linked to a shorter life.” When individuals were exposed to these messages, a tendency to prioritize self-transcendent values was associated with lower reactivity within neural regions implicated in threat responses (amygdala, anterior insula). These findings suggest that reducing neural indicators of threat in response to health-related messaging is a potential way through which transcendent values benefit health.

Pages 379–387;

In an accompanying editorial, Hall et al. provide context for the interpretation of these findings using the brain-as-predictor approach and other recent biobehavioral perspectives involving the use of neuroscience methods in the service of health behavior change.

Pages 376–378;

A meta-analysis by Forsberg et al. investigated whether the magnitude of placebo analgesia is different in patients compared to healthy individuals. Seventy-one studies including 4239 participants revealed that the average effect sizes for patients and healthy individuals were not markedly different. However, there were relatively more studies with patients compared to healthy individuals in which there was a clinically significant reduction in pain. Thus, the data suggest that studying placebos in healthy individuals may underestimate potential benefits in clinical patient samples.

Pages 388–394;

The occurrence and detection of chest pain during an ischemic episode may be critical for self-initiation of treatment and timely presentation to the emergency department for cardiac care. Stébenne et al. explored the associations between positive affect (PA), negative affect (NA), and chest pain reporting in patients with and without ischemia during exercise testing. NA, but not PA, was associated with chest pain in the full sample. Patterns of results differed by the presence or absence of exercise-induced ischemia.

Pages 395–403;

Van Montfort et al. examined the validity of the European Society of Cardiology psychosocial screening instrument in cardiac patients. Factor analysis showed five constructs. Correspondence with validated questionnaires was fair to moderate. Psychological factors reflecting negative affect were predictive of cardiac symptoms at 1-year follow-up. These findings contribute to the search for a valid multidimensional psychosocial screening instrument in cardiology.

Pages 404–415;

Adverse environments may increase cardiovascular risk by inducing “agonistic striving”—a tendency to influence or control other people and relationships. In research with young African American and white adults from disadvantaged neighborhoods, Ewart et al. found that higher salivary cortisol levels predicted higher ambulatory blood pressure, but only in individuals exhibiting agonistic striving.

Pages 416–425;

Pérez et al. examined associations of normal grief and complicated grief—that is, grief that is unresolved and prolonged—with diurnal cortisol patterns in a large study. Participants with complicated grief showed low levels of morning cortisol and low overall diurnal cortisol levels characteristic of a chronic stress reaction.

Pages 426–433;

In a systematic review of 43 studies that examined life course cardiovascular disease (CVD) effects of childhood adversity, Appleton et al. found that most studies reported a positive association, suggesting a dose-response relationship between childhood adversity and CVD risk. The literature would benefit from improving consistency of measurement and considering socioeconomic status as an antecedent factor instead of a component part of an adversity score.

Pages 434–440;

In a sample of 295 women, a history of child abuse or neglect was associated with higher subclinical cardiovascular disease (CVD) as assessed by carotid intima media thickness and carotid plaque. Thurston et al. found that women with a similar abuse or neglect history who slept six or fewer hours a night or experienced hot flashes in sleep showed the highest levels of subclinical CVD measures. Childhood adversity may contribute to increased risk of CVD in women.

Pages 441–449;

Stress has been linked to poor immunologic function and illness in the general adult population, but the impact of stress on immune function has not been well explored during the postpartum period in socially disadvantaged individuals. Guardino et al. found that chronic financial stress at 1 month postpartum predicted higher levels of C-reactive protein (CRP) at 6 and 12 months postpartum and that overweight plays a role in this longitudinal relationship.

Pages 450–460;

Whether there is an association of insomnia with subsequent breast cancer risk is largely unknown. Sen et al. assessed combinations of different components of insomnia for association with incident breast cancer in a large cohort study. Results suggest that suffering from only some aspects of insomnia may not predispose someone to breast cancer. Experiencing multiple insomnia symptoms simultaneously (difficulty initiating sleep, maintaining sleep, and poor quality of sleep) might confer excess breast cancer risk.

Pages 461–468;

Evidence suggests that sleep quality is worse in minorities in comparison to white individuals in the United States. Owens et al. examined the relationship between discrimination and measures of subjective and objective sleep in a racially diverse sample. After adjustments for covariates, respondents with higher discrimination scores were significantly more likely to experience poor sleep efficiency and report poorer sleep quality. Higher discrimination scores were also associated with longer wake after sleep onset and more sleep difficulties.

Pages 469–478;

White et al. investigated whether sex moderated the relationship between depressive symptoms and objective activity and sleep assessments using actigraphy. Higher depression scores were associated with greater sleep disturbance in women and greater rest-activity rhythm disturbance in men. Results highlight the dynamic relationship between sex, depression, sleep, and rest-activity rhythms, and suggest the need to consider these relationships in both assessment and treatment approaches in those with depression.

Pages 479–484;

Patients often have a combination of medical, psychological and social problems, which may impede treatment and recovery from medical and psychological conditions. Van Reedt Dortland et al. validated a self-assessment questionnaire for biopsychosocial care needs, the INTERMED Self Assessment (IMSA). The IMSA is valid, generic, and efficient. The scale can be used in discussions with patients and health care providers to formulate integrated care plans.

Pages 485–492;

Copyright © 2017 by American Psychosomatic Society