Effect of Relocation to the U.S. on Asthma Risk Among Hispanics.

INTRODUCTION: Asthma prevalence is reportedly higher among U.S.-born relative to foreign-born Hispanics/Latinos. Little is known about rates of asthma onset before and after relocation to the U.S. in Latinos. Asthma rates were examined by U.S. residence and country/territory of origin. METHODS: In 2015-2016, age at first onset of asthma symptoms was analyzed, defined retrospectively from a cross-sectional survey in 2008-2011, in relation to birthplace and U.S. residence among 15,573 U.S.-dwelling participants (aged 18-76 years) in the Hispanic Community Health Study/Study of Latinos. RESULTS: Cumulative incidence of asthma through age 30 years ranged from 7.9% among Mexican background individuals to 29.4% among those of Puerto Rican background. Among those born outside the U.S. mainland, the adjusted hazard for asthma was 1.52-fold higher (95% CI=1.25, 1.85) after relocation versus before relocation to the U.S. mainland, with heterogeneity in this association by Hispanic/Latino background (p-interaction<0.0001). Among foreign-born Dominicans and Mexicans, rates of asthma were greater after relocation versus before relocation (adjusted hazard ratio [AHR] for after versus before relocation, 2.42, 95% CI=1.44, 4.05 among Dominicans; AHR=2.90, 95% CI=2.02, 4.16 among Mexicans). Puerto Ricans had modestly increased asthma onset associated with U.S. mainland residence (AHR=1.52, 95% CI=1.06, 2.17). No similar increase associated with U.S. residence was observed among Central/South American immigrants (AHR=0.94, 95% CI=0.53, 1.67). Asthma rates among Cuban immigrants were lower after relocation (AHR=0.45, 95% CI=0.24, 0.82). CONCLUSIONS: The effect of relocation to the U.S. on asthma risk among Hispanics is not uniform across Hispanic/Latino groups.

The effects of safety behaviors on health anxiety: an experimental investigation.

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n=30) or control condition (n=30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the two groups as a function of the manipulation. Mediational analyses were consistent with the hypothesis that changes in the frequency of health-related thoughts mediated the effects of the experimental manipulation on health anxiety. These findings suggest that safety behaviors are associated with increases in health anxiety, perhaps by fostering catastrophic thoughts about health. The implications of these findings for the conceptualization of hypochondriasis as an anxiety disorder are discussed.

Disgust, anxiety, and vasovagal syncope sensations: a comparison of injection-fearful and nonfearful blood donors.

Although research has implicated disgust in the fainting response observed in blood-injection-injury (BII) phobia, this finding has not been consistently observed in the literature. The present study further examines the relationship between disgust and fainting symptoms among injection-fearful (n=108) and nonfearful (n=338) blood donors. Volunteers from community blood drives provided pre-donation levels of anxiety and disgust towards giving blood and completed a standardized measure of vasovagal reactions (fainting) to blood donation after giving blood. As predicted, injection-fearful participants reported significantly more pre-donation anxiety and disgust compared to nonfearful participants. Injection-fearful donors also reported experiencing more fainting symptoms during blood donation and found the donation experience more unpleasant than did nonfearful participants. Although pre-donation disgust and anxiety levels each uniquely predicted fainting symptoms among nonfearful donors, only pre-donation anxiety uniquely predicted fainting symptoms among injection-fearful donors. Implications of these findings for conceptualizing the disgust-faint relationship in BII phobia are discussed.

Vasovagal syncope and blood donor return: examination of the role of experience and affective expectancies.

Vasovagal sensations (e.g., dizziness, nausea, and fainting) are one of the main reasons people find blood donation unpleasant. A better understanding of predictors of vasovagal sensations during blood donation could inform interventions designed to increase donor return rates. The present investigation examined the extent to which experience with blood donation and vasovagal sensations during blood donation uniquely predict the likelihood of donor return, even when controlling for affective expectancies. Participants presenting at community blood drives indicated how many times they have given blood and provided ratings of expected anxiety, pain, disgust, as well as fear of fainting before giving blood. After donating, participants completed a measure of vasovagal sensations experienced during blood donation. They also rated the pleasantness of the experience and willingness to donate blood in the future. The findings showed that experience with blood donation and vasovagal sensations during blood donation uniquely predicted willingness to donate blood in the future even when controlling for age and negative affective expectancies about giving blood. This finding suggests that vasovagal sensations and experience with blood donation have unique (and perhaps additive) effects on willingness to donate blood in the future, suggesting that behavior modification interventions that directly target these variables could potentially increase donor retention.

Fear and disgust processing during repeated exposure to threat-relevant stimuli in spider phobia.

Although disgust plays a significant role in the etiology of spider phobia, there remains a paucity of research examining the role of disgust in the treatment of spider phobia. Spider fearful participants (N = 46) were randomly assigned to a disgust (view vomit images) or neutral activation (view inanimate objects) condition. They were then repeatedly exposed to a videotaped tarantula, during which time their fear, disgust, and physiological levels were assessed repeatedly. Growth curve analyses indicated that repeated exposure led to significant declines in fear and disgust with no statistically significant differences between the two conditions. However, there was marginal evidence for decreased physiological arousal during repeated exposure among spider fearful participants in the disgust activation condition compared to those in the neutral condition. Reduction in disgust during exposure in the disgust activation condition remained significant after controlling for change in fear, whereas change in fear was no longer significant after controlling for change in disgust. However, the opposite pattern of relations between change in fear and disgust was observed in the neutral activation condition. Higher fear and disgust activation during exposure was also associated with higher fear and disgust responding on a subsequent behavioral task and higher spider fear and disgust at 3-month follow-up. Baseline trait disgust propensity also predicted fear and disgust parameters during repeated exposure. The implications of these findings for the role of disgust in the treatment of spider phobia are discussed.