Insomnia and well-being.

Most Americans have occasional problems with insomnia. The relationship of insomnia to illness is well known. However, insomnia may also relate to lower levels of well-being. Although there are various definitions of well-being, one of the most clearly articulated and comprehensive models identifies 2 overarching constructs, psychological well-being and subjective well-being. The purpose in the present study was to assess the relationship between insomnia symptoms and the dimensions of psychological and subjective well-being, adjusting for the potential confound of comorbid physical and psychological illness. The data for the present study came from the National Survey of Midlife Development in the United States, a survey of community-dwelling adults. After adjustment for demographic characteristics and a wide range of chronic mental and physical health conditions, insomnia symptoms were found to have a significant relationship with both psychological and subjective well-being but a stronger relationship to subjective well-being. These data suggest that insomnia symptoms have a stronger relationship to enjoying life than to the perception that one has a meaningful life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic differences in children's health: How and why do these relationships change with age?

The effects of socioeconomic status (SES) on health are well documented in adulthood, but far less is known about its effects in childhood. The authors reviewed the literature and found support for a childhood SES effect, whereby each decrease in SES was associated with an increased health risk. The authors explored how this relationship changed as children underwent normal developmental changes and proposed 3 models to describe the temporal patterns. The authors found that a model's capacity to explain SES-health relationships varied across health outcomes. Childhood injury showed stronger relationships with SES at younger ages, whereas smoking showed stronger relationships with SES in adolescence. Finally, the authors proposed a developmental approach to exploring mechanisms that link SES and child health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Explaining the Link Between Low Socioeconomic Status and Psychopathology: Testing Two Mechanisms of the Social Causation Hypothesis.

Two mechanisms of the hypothesized social causation of psychopathology--differential incidence and cumulative prevalence--were tested over 9 years in a nationally representative sample of 1,075 children and youths, ages 8-17 at Time 1 (1986). Analyses using parental responses on behavior checklists at 4 time points showed significant increases in clinical elevations for those of the lowest socioeconomic status (SES) on anxious/depressed, somatic complaints, thought problems, delinquent, and aggressive syndromes. This SES-linked differential incidence supports the social causation hypothesis that factors associated with SES contribute to variations in levels of psychological problems. SES-linked differential cumulative prevalence was found for withdrawn and somatic complaints; this finding indicates that low-SES cases do not improve as much as do middle- and high-SES cases, which results in greater accumulation of low-SES cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic status and conceptual thinking.

The study attempted to evaluate the importance of the variables of form of symbolism and abstractness-concreteness for status differences on tests of conceptual ability. Five hypotheses were proposed. Subjects were 181 white sixth-grade New York City public school children whose average age was about eleven and who were divided into two groups, HS (N = 99) and LS (N = 82). "As groups, HS children selected more definitions of an abstract type than did the LS group." Other data concerning relationships between socioeconomic status to conceptual ability are presented and discussed. 21 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic Status, Resources, Psychological Experiences, and Emotional Responses: A Test of the Reserve Capacity Model.

The current study used ecological momentary assessment to test several tenets of the reserve capacity model (L.C. Gallo & K. A. Matthews, 2003). Women (N = 108) with varying socioeconomic status (SES) monitored positive and negative psychosocial experiences and emotions across 2 days. Measures of intrapsychic and social resources were aggregated to represent the reserve capacity available to manage stress. Lower SES was associated with less perceived control and positive affect and more social strain. Control and strain contributed to the association between SES and positive affect. Lower SES elicited greater positive but not negative emotional reactivity to psychosocial experiences. Women with low SES had fewer resources relative to those with higher SES, and resources contributed to the association between SES and daily experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpretation of Genetic Risk Feedback Among African American Smokers With Low Socioeconomic Status.

The authors report on factors related to interpretation of feedback on genetic susceptibility to lung cancer among 371 African American smokers receiving care in a community health clinic, with a focus on whether smokers were interpreting feedback consistent with a defensive processing or an accuracy orientation. Smokers were given feedback on the absence (indicating increased risk) or presence (indicating average risk) of the gene for the mu isoform of glutathione S-transferase . Smokers who were told they were at higher risk were more likely to inaccurately recall the result than those deemed at average risk. Smokers who inaccurately recalled the result, regardless of risk status, were most likely to misinterpret the meaning of the result. Perceived lung cancer risks and worries were not associated with comprehension of the test result. The authors suggest additional research is needed to develop more effective strategies for communicating genetic risk feedback to motivate smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic status, schooling, and the developmental trajectories of adolescents.

The socioeconomic stratification of American society profoundly influences how the life course unfolds by shaping various developmental pathways as well as the connections among these pathways. Drawing on a nationally representative sample of American adolescents, this study charted trajectories of personal control and parental consultation from middle school to the end of high school and then examined how various combinations of these trajectories were associated with math/science course taking in high school across socioeconomic strata. Results indicated that low and/or decreasing levels of personal control were associated with the accumulation of fewer math/science credits, as were declining levels of parental consultation no matter what the initial level. Mismatches between control and consultation trajectories (e.g., high, stable control with low, stable consultation) were also associated with fewer math/science credits. These patterns tended to be less predictive of math/science credit accumulation at the highest and lowest ends of the socioeconomic spectrum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic position, health behaviors, and C-reactive protein: A moderated-mediation analysis.

Objective: We sought to understand the link between low socioeconomic position (SEP) and cardiovascular disease (CVD) by examining the association between SEP, health-related coping behaviors, and C-reactive protein (CRP), an inflammatory marker and independent risk factor for CVD, in a U.S. sample of adults. Design: We used a multiple mediation model to evaluate how these behaviors work in concert to influence CRP levels and whether these relationships were moderated by gender and race/ethnicity. Main outcome measures: CRP levels were divided into two categories: elevated CRP (3.1–10.0 mg/L) and normal CRP (≤3.0 mg/L). Results: Both poverty and low educational attainment were associated with elevated CRP, and these associations were primarily explained through higher levels of smoking and lower levels of exercise. In the education model, poor diet also emerged as a significant mediator. These behaviors accounted for 87.9% of the total effect of education on CRP and 55.8% the total effect of poverty on CRP. We also found significant moderation of these mediated effects by gender and race/ethnicity. Conclusion: These findings demonstrate the influence of socioeconomically patterned environmental constraints on individual-level health behaviors. Specifically, reducing socioeconomic inequalities may have positive effects on CVD disparities through reducing cigarette smoking and increasing vigorous exercise. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic status and class: A challenge for the practice of psychology in Canada.

Although Canadian psychology has made great strides in addressing the importance of cultural influences in research and practise, there has been little acknowledgement of socioeconomic status (SES) as an important component of cultural identity. This literature review and discussion explores SES in relation to psychosocial well-being and the provision of psychological services. Psychologists are challenged to incorporate considerations of SES into their work and to be mindful of the ways in which SES interacts with other cultural factors. Recommendations for practise, advocacy, research, and teaching are provided for psychologists who wish to expand their multicultural framework to include SES. Finally, a case study is provided to illustrate how psychologists might consider the influence of SES when working with clients from a systems perspective. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleep-Related Attentional Bias in Good, Moderate, and Poor (Primary Insomnia) Sleepers.

Evidence was sought of an attentional bias toward a highly representative object of the bedroom environment in good, moderate, and poor (primary insomnia) sleepers. Using a flicker paradigm for inducing change blindness, the authors briefly presented a single scene comprising a group of bedroom environment and neutral objects to participants and then briefly replaced this scene with an identical scene containing a change made to either a bedroom environment or a neutral object. In a 3 x 2 entirely between-participants design, change-detection latencies revealed a sleep-related attentional bias in poor sleepers but not in good sleepers. A possible bias in moderate sleepers was also revealed. It is suggested that attentional bias has a role in the perpetuation and possibly precipitation of primary insomnia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic insomnia: Recent advances and innovations in treatment developments and dissemination.

Insomnia is a prevalent public health problem that carries an important psychosocial and economic burden for those affected, their families, employers, and for society at large. Despite its negative impacts, insomnia often remains untreated and, when treatment is initiated, it is predominantly with medication, an option that is not always acceptable to people with insomnia. There is extensive evidence that psychological approaches, primarily cognitive behavioural therapy, are effective, produce durable and generalizable outcomes, and should be the first line therapy for chronic insomnia. Nonetheless, these approaches remain under utilised in clinical (medical) practise. Several innovative and cost-effective treatment delivery models (e.g., telephone consultations, Internet-based treatment) have yielded promising results but despite these advances, there remains a problem of supply. A significant challenge for the future will be to disseminate more efficiently validated therapies and practise guidelines and increase their use in clinical practise. Additional training opportunities are also needed for psychologists to develop expertise in a new emerging behavioural sleep medicine subspecialty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internet-Based Treatment for Insomnia: A Controlled Evaluation.

This study investigated the effects of an Internet-based intervention for insomnia. Participants who met criteria for insomnia (N = 109) were randomly assigned to either a cognitive-behavioral self-help treatment or a waiting list control condition. The 5-week intervention mainly consisted of sleep restriction, stimulus control, and cognitive restructuring. Sleep diary data were collected for 2 weeks at baseline and at posttreatment. The dropout rate was 24% (n = 28). Results showed statistically significant improvements in the treatment group on many outcome measures, including total sleep time, total wake time in bed, and sleep efficiency. However, improvements were also found in the control group. Overall, between-groups effect sizes were low, with the exception of the Beliefs and Attitudes About Sleep Scale (Cohen's d = .81). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Survey of Insomnia Treatment at Canadian Sleep Centres: Is There a Role for Clinical Psychologists?

This survey found that less than 15% of Canadian sleep centres have developed programs for the psychological treatment of insomnia. One in five Canadians suffer from insomnia: the most common sleep complaint confronting health care practitioners. With increasing evidence of the importance of quality sleep for optimal daytime functioning, it is timely to advocate for the development of psychologically-based insomnia programs within Canadian sleep centres. Closer collaboration between clinical psychologists and family physicians in managing insomnia is also required. This paper highlights issues (related to the identification and treatment of sleep disorders) for clinical training of psychologists in Canadian Ph.D. programmes and internship sites. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subjective social status, objective socioeconomic status, and cardiovascular risk in women.

Objective: Subjective perceptions of personal social status may relate to health beyond the effects of objective socioeconomic status (SES). The authors examined the relationship between subjective social status (SSS) and psychosocial, behavioral, and physical cardiovascular risk factors in middle-aged women. Design: Ninety-two women (90.2% White) completed ladder-based, pictorial self-report measures of SSS relative to others in their community and in the United States. Psychosocial measures of depression, anxiety, pessimism, stress, and social support and behavioral risk factors of fruit and vegetable consumption, leisure physical activity, and body-mass index were obtained. In addition, women underwent measurement of clinic blood pressure and assessment of daytime ambulatory systolic and diastolic blood pressure (SBP; DBP) over 2 consecutive days. Results: Community SSS was significantly inversely related to anxiety, pessimism, stress, and daytime ambulatory DBP after controlling for objective SES and U.S. SSS. Women with lower U.S. SSS showed less healthy dietary and exercise behaviors and, contrary to predictions, lower clinic and ambulatory DBP. Conclusion: This study provides additional evidence that perceptions of one's position in the social hierarchy could have important health implications beyond the impact of objective SES. Further, the cardiovascular risk implications of perceived community versus U.S. social status appear to be distinct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affective and cardiovascular effects of experimentally-induced social status.

Objective: Observational research suggests subordinate social status is associated with negative mental and physical health outcomes. However, observational studies have limitations, including confounding of social status with other factors, limited ability to infer causality, and difficulty of obtaining detailed affective and physiologic data. This study used experimental methods to test the hypothesis that subordinate social status per se causes psychological distress and cardiovascular arousal. Design: Forty-four women were randomly assigned to an induced subordinate or dominant status condition. Social status was manipulated using a procedure derived from status construction theory. Main Outcome Measures: Affective responses were assessed via self-report. Cardiovascular responses were assessed by measures of systolic and diastolic blood pressures obtained with an automated blood pressure machine. Results: Participants in the subordinate condition perceived themselves as lower in status; the reverse was true for dominant condition participants. Compared with induced dominant status, induced subordinate status produced increased negative affect and systolic blood pressure over the course of the study. Conclusion: Findings suggest social status can be experimentally manipulated and short-term induction of subordinate status can have adverse effects on affect and stress-related physiological systems. Results have implications for understanding how socioeconomic status "gets under the skin" to influence health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socioeconomic differences in reading trajectories: The contribution of family, neighborhood, and school contexts.

In the present study, the authors use the Early Childhood Longitudinal Study, Kindergarten Cohort of 1998-1999, to examine the extent to which family, school, and neighborhood factors account for the impact of socioeconomic status (SES) on children's early reading. Through the use of hierarchical linear modeling techniques, growth curve models were estimated to depict children's reading trajectories from kindergarten to 3rd grade. Family characteristics made the largest contribution to the prediction of initial kindergarten reading disparities. This included home literacy environment, parental involvement in school, and parental role strain. However, school and neighborhood conditions contributed more than family characteristics to SES differences in learning rates in reading. The association between school characteristics and reading outcomes suggests that makeup of the student population, as indexed by poverty concentration and number of children with reading deficits in the school, is related to reading outcomes. The findings imply that multiple contexts combine and are associated with young children's reading achievement and growth and help account for the robust relation of SES to reading outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health disparities through a psychological lens.

There is growing concern in the United States about avoidable, unjust differences in health associated with sociodemographic characteristics, such as socioeconomic status and race/ethnicity. This concern has sparked research to identify how disparities develop and how they can be reduced. Studies showing that disparities occur at all levels of socioeconomic status, not simply at the very bottom, suggest that psychosocial factors play an important role. The author discusses both content and process issues in psychological research on disparities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Middle class and marginal? Socioeconomic status, stigma, and self-regulation at an elite university.

In four studies, the authors investigated the proposal that in the context of an elite university, individuals from relatively lower socioeconomic status (SES) backgrounds possess a stigmatized identity and, as such, experience (a) concerns regarding their academic fit and (b) self-regulatory depletion as a result of managing these concerns. Study 1, a correlational study, revealed the predicted associations between SES, concerns about academic fit, and self-regulatory strength. Results from Studies 2 and 3 suggested that self-presentation involving the academic domain is depleting for lower (but not higher) SES students: After a self-presentation task about academic achievement, lower SES students consumed more candy (Study 2) and exhibited poorer Stroop performance (Study 3) relative to their higher SES peers; in contrast, the groups did not differ after discussing a nonacademic topic (Study 3). Study 4 revealed the potential for eliminating the SES group difference in depletion via a social comparison manipulation. Taken together, these studies support the hypothesis that managing concerns about marginality can have deleterious consequences for self-regulatory resources. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Association between alcohol intoxication and alcohol-related problems: An event-level analysis.

Heavy-drinking students experience a myriad of alcohol-related negative consequences. Use of event-level data permits predictions to be made regarding (a) the likelihood of alcohol-related consequences occurring after specific drinking events, and (b) moderators of the association between intoxication and consequences. College students (N = 183, 64% female) completed 4 consecutive 7-day drinking diaries and turned them in weekly. The diaries yielded prospective event-level data on daily drinks, time spent drinking, and negative consequences related to each drinking event. Alcohol intoxication on a given day was significantly associated with increased levels of risk, although this association was moderated by average level of intoxication. Furthermore, self-control was associated with increased likelihood of negative consequences at all levels of intoxication, and self-regulation and impulsivity moderated the event-level association between daily intoxication and likelihood of negative consequences. Results suggest that self-regulation subsumes impulsivity and self-control. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moderators of the emotion inhibition-health relationship: A review and research agenda.

The preponderance of a growing literature suggests that emotion inhibition is associated with poorer health. However, although inhibition and health are clearly related, the "inhibition hypothesis" has taken on the flavor of a contemporary dogma. Conceptual bases are accepted uncritically, and developments from other domains of psychology are incorporated in a selective, self-supporting, and unenlightening manner. Theories have been tested in homogenous samples, with little attention paid to possible contributions from ethnic diversity, developmental differences, or period effects. This article presents an evolutionary framework within which to consider these phenomena. It critiques the conceptual underpinnings of inhibition- health theories and provides a rationale for the expectation of moderator effects across cultures, individuals, and emotions. Directions for future empirical work are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)