Relating to the Body Under Chronic Cancer Threat: Implications for Psychosocial Health Among Adolescents and Young Adults with Cancer Predisposition Syndromes.

Purpose: Adolescents and young adults (AYAs) with cancer predisposition syndromes often experience significant physical and psychosocial burdens. These burdens include cancer worry and potentially distressing bodily changes due to risk-reducing procedures (e.g., mastectomy) or cancer treatments. This qualitative-descriptive study explored how AYAs with Li-Fraumeni syndrome (LFS) relate and adjust to their bodies under the chronic threat of cancer. Methods: Participants were enrolled in the National Cancer Institute's LFS study. This analysis included 42 AYAs with LFS aged 15-39 years at enrollment who completed one or two telephone interviews that explored LFS-related bodily experiences and challenges. Transcripts were thematically analyzed. Results: The majority of participants (n = 26/42, 62%) had ≥1 primary cancer. The mean age at first cancer diagnosis was 21 years (range = 0.5-35 years). Participants described challenges relating to the body due to frequent self-monitoring, whole-body magnetic resonance imaging scans, risk-reducing surgeries, and/or cancer treatments. Heightened body awareness and vigilance not only prompted self-protective behaviors but also triggered worry and distress. AYAs coped with bodily changes and concerns by seeking doctors' reassurance, engaging in health-protective behaviors, and reframing perceptions of their altered bodies. Conclusion: Findings suggest AYAs with cancer predisposition syndromes such as LFS experience difficulties relating and adjusting to the body that may compromise psychosocial health. Our results demonstrate that these difficulties may arise across the time course of genetic disease, including before a cancer diagnosis. Clinicians might support AYAs by conducting routine psychosocial risk assessments, providing anticipatory guidance regarding body-related challenges, sharing peer support resources, and referring to mental health providers, as needed.

Measuring Relationship Influences on Romantic Couples' Cancer-Related Behaviors During the COVID-19 Pandemic: Protocol for a Longitudinal Online Study of Dyads and Cancer Survivors.

BACKGROUND: Research has established the effects of romantic relationships on individuals' morbidity and mortality. However, the interplay between relationship functioning, affective processes, and health behaviors has been relatively understudied. During the COVID-19 pandemic, relational processes may influence novel health behaviors such as social distancing and masking. OBJECTIVE: We describe the design, recruitment, and methods of the relationships, risk perceptions, and cancer-related behaviors during the COVID-19 pandemic study. This study was developed to understand how relational and affective processes influence romantic partners' engagement in cancer prevention behaviors as well as health behaviors introduced or exacerbated by the COVID-19 pandemic. METHODS: The relationships, risk perceptions, and cancer-related behaviors during the COVID-19 pandemic study used online survey methods to recruit and enroll 2 cohorts of individuals involved in cohabiting romantic relationships, including 1 cohort of dyads (n=223) and 1 cohort of cancer survivors (n=443). Survey assessments were completed over 2 time points that were 5.57 (SD 3.14) weeks apart on average. Health behaviors assessed included COVID-19 vaccination and social distancing, physical activity, diet, sleep, alcohol use, and smoking behavior. We also examined relationship factors, psychological distress, and household chaos. RESULTS: Data collection occurred between October 2021 and August 2022. During that time, a total of 926 participants were enrolled, of which about two-thirds were from the United Kingdom (n=622, 67.8%) and one-third were from the United States (n=296, 32.2%); about two-thirds were married (n=608, 66.2%) and one-third were members of unmarried couples (n=294, 32%). In cohorts 1 and 2, the mean age was about 34 and 50, respectively. Out of 478 participants in cohort 1, 19 (4%) identified as Hispanic or Latino/a, 79 (17%) as non-Hispanic Asian, 40 (9%) as non-Hispanic Black or African American, and 306 (64%) as non-Hispanic White; 62 (13%) participants identified their sexual orientation as bisexual or pansexual, 359 (75.1%) as heterosexual or straight, and 53 (11%) as gay or lesbian. In cohort 2, out of 440 participants, 13 (3%) identified as Hispanic or Latino/a, 8 (2%) as non-Hispanic Asian, 5 (1%) as non-Hispanic Black or African American, and 398 (90.5%) as non-Hispanic White; 41 (9%) participants identified their sexual orientation as bisexual or pansexual, 384 (87.3%) as heterosexual or straight, and 13 (3%) as gay or lesbian. The overall enrollment rate for individuals was 66.14% and the overall completion rate was 80.08%. CONCLUSIONS: We discuss best practices for collecting online survey data for studies examining relationships and health, challenges related to the COVID-19 pandemic, recruitment of underrepresented populations, and enrollment of dyads. Recommendations include conducting pilot studies, allowing for extra time in the data collection timeline for marginalized or underserved populations, surplus screening to account for expected attrition within dyads, as well as planning dyad-specific data quality checks. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48516.

Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes?

Individuals with inherited cancer syndromes, such as Li-Fraumeni syndrome (LFS), may be motivated to adopt health-protective behaviors, such as eating more fruits and vegetables and increasing physical activity. Examining these health behaviors among young people with high lifetime genetic cancer risk may provide important insights to guide future behavioral interventions that aim to improve health-related quality of life (HRQOL). We used a self-regulatory framework to investigate relationships among diet and physical activity behaviors and psychosocial constructs (e.g., illness perceptions, coping, HRQOL) in adolescents and young adults (AYAs; aged 15-39 years) with LFS. This longitudinal mixed-methods study included 57 AYAs aged 16-39 years at enrollment), 32 (56%) of whom had a history of one or more cancers. Participants completed one or two telephone interviews and/or an online survey. We thematically analyzed interview data and conducted regression analyses to evaluate relationships among variables. AYAs described adopting healthy diet and physical activity behaviors to assert some control over health and to protect HRQOL. More frequent use of active coping strategies was associated with greater reported daily fruit and vegetable intake. Greater reported physical activity was associated with better quality of psychological health. Healthy diet and physical activity behaviors may function as LFS coping strategies that confer mental health benefits. Clinicians might emphasize these potential benefits and support AYAs in adopting health behaviors that protect multiple domains of health. Future research could use these findings to develop behavioral interventions tailored to AYAs with high genetic cancer risk.

Effects of Social Control on Eating and Relational Behaviors in Romantic Relationships.

BACKGROUND: Prior research has shown that social control strategies can have either positive or negative effects on individuals' health behaviors. However, no research has examined the degree to which social control attempts enacted by romantic partners are associated with individuals' relational behaviors or whether perceptions of a partner's motivation to engage in social control moderate links between the use of social control and either health or relational behaviors. PURPOSE: This study investigated (a) the degree to which two classes of social control strategies that romantic partners can use to improve their partners' eating behavior (autonomy-supportive and autonomy-limiting strategies) are associated with eating and relational behaviors, and (b) whether perceptions of the partner's motivation for using social control moderate associations between its use and an individual's eating and relational behavior. METHODS: This study had a daily diary design. One hundred and forty-seven individuals in romantic relationships completed surveys for 14 consecutive days. RESULTS: On days when individuals reported that their partner used autonomy-supportive social control strategies, individuals reported healthier eating and more constructive relational behaviors. There were no effects of autonomy-limiting strategies on eating or relational behavior. Perceptions of a partner's motives did not moderate associations between reported social control and any behavioral outcomes. Moreover, there were no effects of either reported social control strategies or partner motive perceptions across time. CONCLUSION: Romantic partners' perceived use of autonomy-supportive-but not autonomy-limiting-social control has benefits for individuals' health behaviors without incurring notable costs to their romantic relationship.

Associations Between Parents' Health and Social Control Behaviors and Their Adolescent's Self-Efficacy and Health Behaviors: Insights From the Family Life, Activity, Sun, Health, and Eating (FLASHE) survey.

BACKGROUND: Parents can influence their children to live healthier lifestyles by modeling healthy behaviors and/or trying to persuade their children to engage in healthier activities. Adolescents and their parents tend to have similar eating and exercise patterns, but less is known about the simultaneous influence of parent's health behavior and social control on adolescents' self-efficacy and health behaviors, including whether their effect is moderated by parenting style. PURPOSE: We examine the degree to which parents' social control and health behaviors are associated with their adolescent's self-efficacy and health behaviors, including whether parenting styles moderate these associations. METHOD: We analyzed data from the Family Life, Activity, Sun, Health, and Eating project. RESULTS: We found that parents' own health behaviors are positively and strongly associated with their adolescent's health behaviors across four domains: fruit/vegetable consumption, junk food consumption, physical activity, and nonacademic screen time. We found positive, moderate-to-strong associations between parents' use of social control and their adolescents' fruit/vegetable and junk food consumption, small negative associations with screen time, and no associations with physical activity. The effects of social control for junk food consumption and screen time, however, depended on parents' own behavior in those domains. Parent responsiveness moderated the relation between parents' social control and their adolescent children's self-efficacy and health behaviors. CONCLUSIONS: The health behaviors parents model and their social control efforts are associated with their adolescents' beliefs and behavior. Efforts to leverage parents as sources of influence must consider the context in which influence is enacted.

The Dyadic Health Influence Model.

Relationship partners affect one another's health outcomes through their health behaviors, yet how this occurs is not well understood. To fill this gap, we present the Dyadic Health Influence Model (DHIM). The DHIM identifies three routes through which a person (the agent) can impact the health beliefs and behavior of their partner (the target). An agent may (a) model health behaviors and shape the shared environment, (b) enact behaviors that promote their relationship, and/or (c) employ strategies to intentionally influence the target's health behavior. A central premise of the DHIM is that agents act based on their beliefs about their partner's health and their relationship. In turn, their actions have consequences not only for targets' health behavior but also for their relationship. We review theoretical and empirical research that provides initial support for the routes and offer testable predictions at the intersection of health behavior change research and relationship science.

Dyadic concordance and associations of beliefs with intentions to learn carrier results from genomic sequencing.

Although romantic couple concordance has been demonstrated across a wide array of health behaviors, little research has examined dyadic concordance in health beliefs. This study examined the extent to which cohabitating romantic dyads' attitudes and beliefs coincide (i.e., dyadic concordance) in addition to how well they predict intentions to learn genomic sequencing results. The actor-partner interdependence model was applied to cross-sectional data from 81 dyads in an exome sequencing study who were surveyed about their risk perceptions, worry, information avoidance, attitudes, and intentions toward learning carrier results. Information avoidance tendencies were positively correlated between partners, but there was low concordance on other beliefs. Individuals' attitudes and information avoidance predicted their own intentions to learn results. Additionally, partners' information avoidance tendencies predicted their partner's intentions to learn results. Future research should explore mechanisms through which one's partner's information avoidance may affect one's own intentions and behaviors.

Accuracy in Perceptions of Fundamental Social Motives: Comparisons to Perceptions of Big Five Traits and Associations With Friendship Quality.

Accurately perceiving others' personalities helps people to successfully navigate their social relationships. However, it is not yet clear whether people can accurately perceive one aspect of people's personalities that may be especially important to understand: motivations. Using the fundamental social motives framework, we examined the extent to which people accurately perceived a friend's motivations (vs. big five traits) and how this was related to friendship quality. A sample of friend dyads completed both self- and friend-assessments of the big five traits and the fundamental motives, and rated friendship quality. Perceivers accurately detected their friend's unique, self-reported ordering of motives (i.e., distinctive accuracy), though to a lesser extent than traits. However, accuracy for motives and traits was positively associated with greater friendship quality to a similar extent. Importantly, these associations emerged above and beyond tendencies to view others highly normatively, as socially desirable, and as similar to the self.

Interpersonal effects of parents and adolescents on each other's health behaviours: a dyadic extension of the theory of planned behaviour.

OBJECTIVE: Interpersonal relationships are important predictors of health outcomes and interpersonal influences on behaviours may be key mechanisms underlying such effects. Most health behaviour theories focus on intrapersonal factors and may not adequately account for interpersonal influences. We evaluate a dyadic extension of the Theory of Planned Behaviour by examining whether parent and adolescent characteristics (attitudes, subjective norms, perceived behavioural control and intentions) are associated with not only their own but also each other's intentions/behaviours. DESIGN: Using the Actor-Partner Interdependence Model, we analyse responses from 1717 parent-adolescent dyads from the Family Life, Activity, Sun, Health, and Eating study. MAIN OUTCOME MEASURES: Adolescents/parents completed self-reports of their fruit and vegetable consumption, junk food and sugary drinks consumption, engagement in physical activity, and engagement in screen time sedentary behaviours. RESULTS: Parent/adolescent characteristics are associated with each other's health-relevant intentions/behaviours above the effects of individuals' own characteristics on their own behaviours. Parent/adolescent characteristics covary with each other's outcomes with similar strength, but parent characteristics more strongly relate to adolescent intentions, whereas adolescent characteristics more strongly relate to parent behaviours. CONCLUSIONS: Parents and adolescents may bidirectionally influence each other's health intentions/behaviours. This highlights the importance of dyadic models of health behaviour and suggests intervention targets.

Attachment and Jealousy: Understanding the Dynamic Experience of Jealousy Using the Response Escalation Paradigm.

Jealousy is a complex, dynamic experience that unfolds over time in relationship-threatening situations. Prior research has used retrospective reports that cannot disentangle initial levels and change in jealousy in response to escalating threat. In three studies, we examined responses to the Response Escalation Paradigm (REP)-a 5-stage hypothetical scenario in which individuals are exposed to increasing levels of relationship threat-as a function of attachment orientations. Highly anxious individuals exhibited hypervigilant, slow escalation response patterns, interfered earlier in the REP, felt more jealousy, sadness, and worry when they interfered, and wanted to engage in more vigilant, destructive, and passive behaviors aimed at their partner. Highly avoidant individuals felt more anger when they interfered in the REP and wanted to engage in more partner-focused, destructive behaviors. The REP offers a dynamic method for inducing and examining jealousy and introduces a novel approach to studying other emotional experiences.

Childhood abuse and neglect and physical health at midlife: Prospective, longitudinal evidence.

Previous research suggests that the experience of abuse and neglect in childhood has negative implications for physical health in adulthood. Using data from the Minnesota Longitudinal Study of Risk and Adaptation (N = 115), the present research examined the predictive significance of childhood physical abuse, sexual abuse, and physical/cognitive neglect for multilevel assessments of physical health at midlife (age 37-39 years), including biomarkers of cardiometabolic risk, self-reports of quality of health, and a number of health problems. Analyses revealed that childhood physical/cognitive neglect, but not physical or sexual abuse, predicted all three health outcomes in middle adulthood, even when controlling for demographic risk factors and adult health maintenance behaviors. We discuss possible explanations for the unique significance of neglect in this study and suggest future research that could clarify previous findings regarding the differential impact of different types of abuse and neglect on adult health.