Examining Links Between Distinct Affective States and Tobacco Lapse During a Cessation Attempt Among African Americans: A Cohort Study.

BACKGROUND: Affect states are posited to play a pivotal role in addiction-related processes, including tobacco lapse (i.e., smoking during a quit attempt), and distinct affective states (e.g., joy vs. happiness) may differentially influence lapse likelihood. However, few studies have examined the influence of distinct affective states on tobacco lapse. PURPOSE: This study examines the influence of 23 distinct affect states on tobacco lapse among a sample of tobacco users attempting to quit. METHODS: Participants were 220 adults who identified as African American (50% female, ages 18-74). Ecological momentary assessment was used to assess affect and lapse in real-time. Between and within-person associations testing links between distinct affect states and lapse were examined with multilevel modeling for binary outcomes. RESULTS: After adjusting for previous time's lapse and for all other positive or negative affect items, results suggested that at the between-person level, joy was associated with lower odds of lapse, and at the within-person level, attentiveness was associated with lower odds of lapse. Results also suggested that at the between-person level, guilt and nervous were associated with higher odds of lapse, and at the within-person level, shame was associated with higher odds of lapse. CONCLUSIONS: The present study uses real-time, real-world data to demonstrate the role of distinct positive and negative affects on momentary tobacco lapse. This work helps elucidate specific affective experiences that facilitate or hinder the ability to abstain from tobacco use during a quit attempt.

Mean affect and affect variability may interact to predict inflammation.

INTRODUCTION: Individuals with greater affect variability (i.e., moment-to-moment fluctuations possibly reflecting emotional dysregulation) are at risk for greater systemic inflammation, which is associated with cardiovascular disease. Some evidence suggests that affect variability is linked with poorer health indicators only among those with higher average levels of affect, particularly for positive affect (PA), and that associations may be non-linear. The present study sought to examine whether links between both PA and negative affect (NA) variability and inflammation are moderated by average level of affect. METHODS: Participants (N = 300, 50 % female, ages 21-70, 60 % non-Hispanic White, 19 % Hispanic, 15 % non-Hispanic Black) completed a lab assessment and provided a blood sample to measure systemic inflammation (i.e., TNF-α, IL-6, CRP). Affect was collected via a two-day ecological momentary assessment protocol where reports were collected about every 45-min during waking hours. Momentary affect ratings were averaged across both days (i.e., iM), separately for PA and NA, for each participant. Affect variability was calculated as the person-specific SD (i.e., iSD) of affect reports, separately for PA and NA. Linear and quadratic interactions were tested. Models included covariates for sex, race, and body mass index. RESULTS: There were significant interactions between NA iM and NA iSD predicting TNF-α (b = 6.54; p < 0.05) and between PA iM and PA iSD predicting IL-6 (b = 0.45; p < 0.05). Specifically, the association between these affect variability indicators and inflammatory markers were suggestive of a positive association among those with higher average affect but a negative association among those with lower average affect. There was no evidence of non-linear associations between affect and inflammation. DISCUSSION: Incorporating interactive effects between affect variability and average affect may be an important consideration in understanding affective-inflammatory associations.

Intra-individual Associations of Perceived Stress, Affective Valence, and Affective Arousal with Momentary Cortisol in a Sample of Working Adults.

BACKGROUND: Research pairing ecological momentary assessment (EMA) methodology and ambulatory cortisol during daily life is still rare, as is careful testing of the within-person associations between stress, affect, and cortisol. Using a circumplex approach, we considered both valence and arousal components of affect. PURPOSE: To examine the within-person covariation of momentary cortisol with momentary perceived stress, affective valence, and affective arousal in everyday life. METHODS: 115 working adults (Mage = 41.2; 76% women; 76% white) completed six EMA surveys per day over 3 days. Each assessment included reports of perceived stress and affect (used to construct indicators of affective valence and arousal), followed by a saliva sample (from which cortisol was assessed). Multi-level models were used to examine the momentary associations between perceived stress, affective valence, affective arousal, and cortisol. RESULTS: Moments characterized by higher perceived stress were associated with higher cortisol (p = .036). Affective valence covaried with cortisol (p = .003) such that more positive valence was associated with lower cortisol and more negative valence with higher cortisol. Momentary affective arousal was not related to cortisol (p = .131). When all predictors were tested in the same model, only valence remained a significant predictor of cortisol (p = .047). CONCLUSION: Momentary perceived stress and affective valence, but not affective arousal, were associated with naturalistic cortisol. Cortisol was more robustly associated with affective valence than perceived stress or affective arousal. These findings extend our understanding of how moments of stress and particular characteristics of affective states (i.e., valence but not arousal) may "get under the skin" in daily life.

Positive and Negative Affect and Salivary Markers of Inflammation Among Young Adults.

BACKGROUND: Emerging evidence suggests that higher circulating levels of inflammatory biomarkers in blood are associated with higher negative affect (NA) and lower positive affect (PA). To our knowledge, the unique associations between NA and PA in daily life and salivary biomarkers of inflammation have not been examined. This study examined these associations in young adults. METHODS: Measures of NA and PA were created from aggregated daily measures of affect (morning and evening ratings averaged across 14 days). We investigated associations between these measures and salivary C-reactive protein (CRP) and interleukin (IL)-6 in a sample of 108 young adults (60% female, mean age = 20.45 ± 1.47), a subset of whom had self-reported chronic back pain (n = 49). CRP and IL-6 were determined from saliva obtained at the end of the daily diary period. RESULTS: After covarying for age, gender, body mass index, chronic pain status, salivary flow rate, and NA, higher PA was associated with lower salivary CRP (ß = - 0.02, 95% CI (- 0.03, - 0.00) sr2 = .06, p = .01) but not IL-6; removing NA from this model did not change results. In a model with the same covariates (and PA), NA was not significantly related to CRP or IL-6. Chronic back pain status and gender did not moderate results. CONCLUSIONS: Findings suggest that higher PA may be associated with lower salivary CRP in young adults, even after accounting for NA and demographic characteristics. Findings highlight the utility of assessing emotional states in relation to salivary markers of inflammation in future biobehavioral research.

Negative and positive affect as predictors of inflammation: Timing matters.

Very little research has assessed how measures of negative and positive affect (NA and PA) derived from assessments at multiple time points per day (e.g., via ecological momentary assessment [EMA]), as opposed to questionnaires that rely on recall over a longer period, are related to levels of peripheral inflammation. We examined how different indicators of NA and PA predicted concentrations of C-reactive protein (CRP) and seven peripheral inflammatory cytokines (IL-1ß, IL-6, TNF-α, IL-8, IL-4, IL-10, and IFN-γ) that were examined in the form of an inflammatory composite. A community-based sample of 220 adults (62% Black/African-American and 25% Hispanic/Latino; aged 25-65; 65% female) completed questionnaires at baseline (including recalled affect "over the past month") and then provided EMA reports 5x/day for 14 days. Blood was drawn from each participant after completion of EMA and used to determine plasma levels of CRP and cytokines. Analyses examined if indicators of affect predicted inflammation, controlling for age, gender, body mass index, education, health conditions, and statin use. Neither recalled NA or PA nor momentary NA or PA (aggregated across the 14 days of EMA) were significantly associated with the cytokine composite or CRP. Negative mood more proximal to the blood draw (i.e., aggregated momentary NA in week 2 of EMA) was associated with the cytokine composite but not CRP. Exploratory moderation analyses revealed that the cytokine composite was also associated with PA in week 2 for men only, and with recalled NA for those with lower education. Exploratory analyses around temporal dynamics suggested that the timing of NA measurement relative to the blood draw mattered: Specifically, there were stronger trends of association between momentary NA and inflammatory cytokines when NA was assessed closer in time to blood collection. Future investigation of the relevance of temporal proximity and other measurement details may improve understanding of how affect relates to inflammation.

Cardiovascular risk, social vigilance, and stress profiles of male law enforcement officers versus civilians.

This study examined the cardiovascular disease (CVD) risk profiles of male law enforcement officers (LEOs) and civilians. CVD risk profiles were based on data collected using traditional objective (e.g., resting BP, cholesterol), novel objective (e.g., ambulatory BP) and self-report measures (e.g., EMA social vigilance). A subset of male LEOs (n = 30, M age = 41.47, SD = 8.03) and male civilians (n = 120, M age = 40.73, SD = 13.52) from a larger study were included in analyses. Results indicated LEOs had significantly higher body mass index [BMI], 31.17 kg/m2 versus 28.87 kg/m2, and exhibited significantly higher trait and state social vigilance across multiple measures, whereas perceived stress was higher among civilians. Findings highlight the need for future research examining CVD risk associated with occupational health disparities, including attributes of individuals entering certain professions as well as experiential and environmental demands of the work.

Increasing the reach of evidence-based interventions for weight management and diabetes prevention among Medicaid patients: study protocol for a pilot Sequential Multiple Assignment Randomised Trial.

INTRODUCTION: Over 40% of US adults meet criteria for obesity, a major risk factor for chronic disease. Obesity disproportionately impacts populations that have been historically marginalised (eg, low socioeconomic status, rural, some racial/ethnic minority groups). Evidence-based interventions (EBIs) for weight management exist but reach less than 3% of eligible individuals. The aims of this pilot randomised controlled trial are to evaluate feasibility and acceptability of dissemination strategies designed to increase reach of EBIs for weight management. METHODS AND ANALYSIS: This study is a two-phase, Sequential Multiple Assignment Randomized Trial, conducted with 200 Medicaid patients. In phase 1, patients will be individually randomised to single text message (TM1) or multiple text messages (TM+). Phase 2 is based on treatment response. Patients who enrol in the EBI within 12 weeks of exposure to phase 1 (ie, responders) receive no further interventions. Patients in TM1 who do not enrol in the EBI within 12 weeks of exposure (ie, TM1 non-responders) will be randomised to either TM1-Continued (ie, no further TM) or TM1 & MAPS (ie, no further TM, up to 2 Motivation And Problem Solving (MAPS) navigation calls) over the next 12 weeks. Patients in TM+ who do not enrol in the EBI (ie, TM+ non-responders) will be randomised to either TM+Continued (ie, monthly text messages) or TM+ & MAPS (ie, monthly text messages, plus up to 2 MAPS calls) over the next 12 weeks. Descriptive statistics will be used to characterise feasibility (eg, proportion of patients eligible, contacted and enrolled in the trial) and acceptability (eg, participant opt-out, participant engagement with dissemination strategies, EBI reach (ie, the proportion of participants who enrol in EBI), adherence, effectiveness). ETHICS AND DISSEMINATION: Study protocol was approved by the University of Utah Institutional Review Board (#00139694). Results will be disseminated through study partners and peer-reviewed publications. TRIAL REGISTRATION NUMBER: clinicaltrials.gov; NCT05666323.

Associations between positively valenced affect and health behaviors vary by arousal.

Evidence is mixed with regard to whether positively valanced affect (PA) is associated with engagement in health behaviors. Both affective arousal (activated/deactivated) and level of analysis (between and within-person) may influence such associations. Adults (N = 121; 25-65 years) completed ambulatory assessments of affect and daily reports of sleep, diet, and physical/sedentary activity. Patterns of association were generally consistent at between and within-person levels, although associations varied by arousal. Activated PA was positively associated with action tendencies (i.e., higher physical activity, lower sedentary activities) and riskier behaviors (such as poor diet) whereas deactivated PA was positively associated with engaging in satiety and rest (i.e., better diet, better sleep quality, and more sedentary activity). Results were maintained when covarying for indicators of relative socioeconomic advantage and neuroticism. Overall, arousal appears to be related to the nature of the associations between PA and health behaviors, highlighting the importance of assessing and evaluating a range of arousal states.

Stress-responses to ostracism: Examining cortisol and affective reactivity to in-person and online exclusion.

Ostracism is associated with poor outcomes, but it is unclear if online versus in-person ostracism elicits divergent psychological and physiological responses. Participants (N = 54) were randomly assigned to online or in-person ostracism, and provided pre- and post-ostracism measures of affect, self-esteem, self-feelings, and salivary cortisol. No significant changes in negative affect, self-esteem, or self-feelings emerged, nor were there differences by ostracism condition. Both ostracism conditions decreased positive affect (stronger online) and lowered cortisol. Extending prior work, ostracism appears to reliably decrease positive affect (especially online) but may not be threatening to the self; moreover, ostracism may reliably elicit acute cortisol declines.

Individuals with both higher recent negative affect and physical pain have higher levels of C-reactive protein.

Conceptualizing physical pain and negative affect as potentially interactive, we hypothesized that higher levels of peripheral inflammatory markers would be observed consistently only among individuals with both higher negative affect and pain symptomatology. Participants were generally healthy midlife adults from the Bronx, NY (N â€‹= â€‹212, M age â€‹= â€‹46.77; 60.8% Black, 25.5% Hispanic/Latina/o) recruited as part of a larger study. Key measures were: reported pain intensity and pain interference at baseline, recent negative affect averaged from self-reports 5x/day for 7 days, and peripheral inflammatory markers (C-reactive protein [CRP] and a composite cytokine measure based on seven cytokines). Controlling for age, BMI, gender, and education, recent negative affect significantly interacted with both pain variables to explain variance in CRP, with higher CRP levels observed only in individuals with both higher negative affect and either higher pain intensity or pain interference. These findings contribute to an emerging literature suggesting that negative affect, pain, and inflammation are related in important and complex ways.

Positive affect and peripheral inflammatory markers among adults: A narrative review.

BACKGROUND: Previous research suggests that positive affect (PA) may promote health and longevity and that one potential mechanism involves inflammation. However, it remains unclear to what extent PA is associated with specific inflammatory markers and whether such associations are driven by main effects of PA and/or due to PA operating as a stress-buffer. METHODS: The present narrative review incorporates studies (N = 28) that have examined the association between PA and peripheral inflammatory markers obtained using venous puncture or dried blood spots. We separate results by whether the study tested direct effects or stress-buffering, and by type of inflammatory marker [including C-reactive protein (CRP), and proinflammatory and anti-inflammatory cytokines], also paying close attention to type of PA assessment (state, aggregated state, or retrospective, the latter involving recall over one to two weeks), and study design (cross-sectional, longitudinal, and experimental). RESULTS: Limited evidence suggests that studies were more supportive of a stress-buffering association, compared to a relatively direct association. When significant direct associations were observed, results suggested that studies using measures of state/aggregated PA exhibited more consistent associations with inflammatory markers than studies using retrospective PA. When significant, higher PA tended to be associated with lower pro- and anti-inflammatory markers, suggestive of lower overall inflammatory load. DISCUSSION: Recommendations for the field and future research are discussed, including the value of utilizing state/aggregated PA measures and of examining stress-buffering mechanisms.

Daily associations between affect and alcohol use among adults: The importance of affective arousal.

OBJECTIVE: Little is known about whether level of affective arousal (i.e., high vs. low) is associated with alcohol use and whether this relationship differs by valence (i.e., positive vs. negative affect) among adults. METHODS: Participants were n = 93 self-reported current drinkers (ages 25-65) who reported positive (PA) and negative affect (NA) seven times a day and alcohol use once a day for seven consecutive days. For each individual, mean levels of high arousal PA (e.g., excited), low arousal PA (e.g., satisfied), high arousal NA (e.g., frustrated), and low arousal NA (e.g., sad) were computed for each day. RESULTS: Alcohol use was reported on 30% of person-days, with an average of 2.3 drinks consumed on drinking days. Heavy episodic drinking (4+/5+ drinks for women/men) occurred on 4% of days. After covarying for age, gender, and weekday, days with higher-than-usual levels of high arousal PA were associated with a 52% increase in the odds of consuming any alcohol and a 105% increase in the odds of engaging in heavy episodic drinking. Individuals reporting more low arousal PA on average had a 77% increase in the odds of heavy episodic drinking. No significant associations between high or low arousal NA and alcohol use were found. CONCLUSIONS: Greater PA, but not NA, was associated with heavy alcohol use at both the within- and between-person levels, perhaps attributable to social and enhancement drinking motives. Results differed by arousal, highlighting the importance of considering a wide range of affective states when examining alcohol use behavior.

Influence of ecological momentary assessment study design features on reported willingness to participate and perceptions of potential research studies: an experimental study.

OBJECTIVE: Intensive ambulatory assessment, such as ecological momentary assessment (EMA), is increasingly used to capture naturalistic patient-reported outcomes. EMA design features (eg, study duration, prompt frequency) vary widely between studies, but it is not known if such design decisions influence potential subjects' willingness to participate in a study. We hypothesise that intentions to participate will be higher in studies that are less burdensome and have higher reward (eg, compensation). DESIGN: This experimental study examined if four EMA study design features (study duration, prompt frequency, prompt length, compensation) affected intentions to participate in a hypothetical EMA study and participation appraisals (eg, participation effort). Participants were randomly assigned to conditions (reflecting a fully crossed design of the four features, each with two levels). Each condition presented a vignette describing a study (each a unique combination of design features) and asked them to report on likelihood of participating and study appraisals. PARTICIPANTS: A convenience sample of participants (n=600; 46% female, Mage=40.39) were recruited using an online service. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were willingness to participate (No/Yes) and reported participation likelihood (0-100 scale). Secondary outcomes included appraisals of interest, enjoyment, effort, and if the study makes a valuable contribution to science. RESULTS: We examined main effects, and two-way interactions for participation likelihood, across study design features. Overall, reported willingness to participate and participation likelihood were high (89%, M=83.90, respectively). Shorter study duration, fewer prompts, shorter prompts and higher compensation increased willingness to participate and elicited higher participation likelihood (each associated with ~6%-8% increases). Findings suggested that more intensive studies were judged as somewhat less interesting and enjoyable, and requiring more effort. CONCLUSION: Hypotheses were generally supported. Design features influence behavioural intentions to participate in, and appraisals of, EMA studies. Implications for participant recruitment and generalisability, and remaining research questions, are discussed.

Daily Links Between Sleep and Anger Among Spouses of Chronic Pain Patients.

OBJECTIVES: This study identified daily associations between sleep, emotion, and marital functioning in the context of chronic pain. Because spouses' sleep is compromised on nights when patients experience more pain, we set out to identify implications of spouses' sleep for their own emotion (anger) upon waking and marital interaction (marital tension) throughout the rest of the day. We further considered whether spouses' critical attitudes about patients' pain-related coping exacerbated associations between their sleep, morning anger, and marital tension. METHOD: Data came from a study of knee osteoarthritis patients (50+ years old) and spouses (N = 138 couples) who completed daily diaries across 22 days. Multilevel models were estimated to test hypotheses. RESULTS: Spouses woke up angrier on mornings when they reported that their sleep was more unrefreshing than usual. This association was stronger among more critical spouses. Morning anger resulting from unrefreshing sleep, however, did not predict marital tension throughout the rest of the day. DISCUSSION: Findings highlight the potential value of intervention efforts aimed at promoting spouses' sleep quality in an effort to offset negative emotional consequences that may undermine spouses' and patients' adjustment in the context of chronic pain.

Affect variability and inflammatory markers in midlife adults.

OBJECTIVE: Higher affect variability (the extent to which individuals vary in their affect over time) has been associated with poorer health indicators, but associations with inflammation are less well understood. The purpose of the present study was to examine whether affect variability was associated with inflammation in ways consistent with the stability theory or the fragile positive affect theory, and whether associations were linear or nonlinear. METHOD: In a racially diverse sample (N = 231; Aged 25-65; 65% female; 62% Black; 25% Hispanic), we examined whether positive affect (PA) and negative affect (NA) variability exhibited linear or quadratic associations with circulating inflammatory cytokines (a composite measure comprised of IL-1ß, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ), and C-reactive protein (CRP) and whether person-mean affect moderated these associations. Affective states were assessed using ecological momentary assessments (EMAs) 5 times per day for 2 weeks, with a blood draw at the end of the EMA period. Individual standard deviations of affective states indexed affect variability. RESULTS: A quadratic association indicated that moderate NA variability was associated with lower CRP. There was evidence of significant moderation by linear associations with PA only: For those with higher person-mean PA, PA variability was positively associated with the cytokine composite. Both person-mean PA and person-mean NA moderated quadratic associations, such that for those with high person-mean affect, both high and low affect variability was associated with systemic inflammation. CONCLUSION: Results are in line with fragile affect theory suggesting that associations between affect variability and health indicators may vary by person-mean affect. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The effects of a short-term mindfulness meditation intervention on coping flexibility.

Background and objectives: Mindfulness meditation (MM) training promotes health and well-being. One potential mechanistic link between MM and health may be coping flexibility, (e.g., the ability to monitor and modify coping strategies based on situational needs and strategy effectiveness). We hypothesized that MM training would increase coping flexibility and also explored whether gains in coping flexibility continued to increase after training, or whether they were maintained or lost with time. Methods and design: One hundred thirteen students (71 female, Mage = 18.97) were randomly assigned to a waitlist control or MM condition. Participants in the MM condition were trained by a certified MM instructor and given guided recordings for one-week of at-home practice. Participants provided reports of coping flexibility over a three-week span. Results: Results from multilevel modeling indicated that MM increased coping flexibility among those in the MM condition and among those who spent relatively more time meditating. Results further suggested that the gains in coping flexibility that were evident at post-test were not only maintained but increased in the two weeks after the intervention. Conclusions: This study provides preliminary support for the assertion that MM increases the ability to monitor and modify coping strategies during times of stress.

Clarifying the Associations between Mindfulness Meditation and Emotion: Daily High- and Low-arousal Emotions and Emotional Variability.

BACKGROUND: Research examining the effects of mindfulness meditation (MM) on emotion seldom considers differences by arousal level or emotion variability. METHODS: In the present study, 115 participants (64% Female, 72% White, Mage = 19.03) were randomly assigned to a brief MM intervention condition (n = 60) or a wait-list control condition (n = 51). Participants in the MM condition were trained in MM and instructed to practice MM daily for one week. All participants provided daily diary reports of both higher- and lower-arousal positive (PE) and negative (NE) emotions. Emotions were weighted by valence and arousal. Multilevel modeling was used to examine valence, arousal, and their interaction; multivariate regression was used to examine emotional variability. RESULTS: More time spent meditating (but not the MM condition itself) was associated with increased lower arousal emotions, and exhibited a significant effect on the interaction between valence and arousal. Examination of individual emotion items suggested that more time meditating significantly predicted increased feelings of quiet and calm and marginally increased relaxation and sleepiness among participants, but did not predict any other emotions assessed in daily life. MM was not associated with emotional variability. CONCLUSION: These results may suggest that PE should be separated by arousal when examining the effects of MM interventions.

Is Perceived Growth Associated with Momentary Indicators of Health and Well-Being in People with Asthma or Rheumatoid Arthritis?

BACKGROUND: Perceived growth (PG) refers to perceptions of positive changes that unfold over time after experiencing trauma. Higher PG is often associated with positive long-term health, but the processes through which PG may influence health are unclear. The present study examines two potential pathways among individuals living with asthma or RA: (1) by promoting momentary indicators of health and well-being in everyday life, and (2) by buffering against stress. METHOD: In a micro-longitudinal design, 128 participants with asthma (n = 97) or rheumatoid arthritis (n = 31) reported perceived growth using the Post-Traumatic Growth (PTG) Inventory and subsequently completed ecological momentary assessments (EMAs) for one week. Participants were signaled five times a day to report on health-related indicators, including affect, disease interference, social interactions, and stress. RESULTS: Multilevel modeling revealed that higher PTG was associated with significantly less negative affect and greater positive affect in everyday life. There were no significant associations between PTG and momentary disease interference, pleasantness of social interactions, or stress, nor evidence that PTG buffered against effects of stress on health-related outcomes. CONCLUSIONS: This research highlights the utility of examining PG in everyday life. Results suggest that closer examination of momentary affect as a process by which PG may facilitate positive health outcomes is warranted.