Correction: Social Media Use and Its Concurrent and Subsequent Relation to a Biological Marker of Inflammation: Short-Term Longitudinal Study.

[This corrects the article DOI: 10.2196/46309.].

Sleep quality impacts the link between reactivity to uncertain threat and anxiety and alcohol use in youth.

Individual differences in reactivity to unpredictable threat (U-threat) have repeatedly been linked to symptoms of anxiety and drinking behavior. An emerging theory is that individuals who are hyper-reactive to U-threat experience chronic anticipatory anxiety, hyperarousal, and are vulnerable to excessive alcohol use via negative reinforcement processes. Notably, anxiety and alcohol use commonly relate to disruptions in sleep behavior and recent findings suggest that sleep quality may impact the link between reactivity to U-threat and psychiatric symptoms and behaviors. The aim of the current study was to examine the unique and interactive effects of reactivity to U-threat and sleep quality on anxiety symptoms and drinking behavior in a cohort of youth, ages 16-19 years. Participants (N = 112) completed a well-validated threat-of-shock task designed to probe individual differences in reactivity to U-threat and predictable threat (P-threat). Startle eyeblink potentiation was recorded during the task as an index of aversive reactivity. Participants also completed well-validated self-report measures of anxiety and depression symptoms, lifetime alcohol use, and current sleep quality. Results revealed significant startle reactivity to U-threat by sleep quality interactions on anxiety symptoms and lifetime drinking behavior. At high levels of sleep disturbance (only), greater reactivity to U-threat was associated with greater anxiety symptoms and total number of lifetime alcoholic beverages. These results suggest that sensitivity to uncertainty and chronic hyperarousal increases anxiety symptoms and alcohol use behavior, particularly in the context of poor sleep quality.

Social Media Use and Its Concurrent and Subsequent Relation to a Biological Marker of Inflammation: Short-Term Longitudinal Study.

BACKGROUND: Although many studies have examined the impact of social media use (SMU) on mental health, very few studies have examined the association of SMU with health-relevant biomarkers. OBJECTIVE: Addressing this gap, we conducted a short-term longitudinal study examining the link between SMU and C-reactive protein (CRP), a biological marker of systemic inflammation predictive of major depression, chronic diseases, and mortality. METHODS: We measured college students' weekly amount of SMU for 5 consecutive weeks objectively via the Screen Time app and collected blood samples at baseline and 5 weeks later. RESULTS: In separate cross-sectional analyses conducted at phase 1 (baseline) and at phase 2 (5 weeks after baseline), objective SMU had a positive, concurrent association with CRP at both time points. Critically, in a longitudinal analysis, more SMU between phase 1 and phase 2 predicted increased CRP between these time points, suggesting that increased SMU led to heightened inflammation during that period. CONCLUSIONS: Although more research is needed to understand why SMU led to higher inflammation, the association between objective SMU and a marker of a biological process critical to physical health presents an intriguing opportunity for future research on social media effects.

Can inflammation predict social media use? Linking a biological marker of systemic inflammation with social media use among college students and middle-aged adults.

Drawing on recent evidence that inflammation may promote social affiliative motivation, the present research proposes a novel perspective that inflammation may be associated with more social media use. In a cross-sectional analysis of a nationally representative sample, Study 1 (N = 863) found a positive association between C-reactive protein (CRP), a biomarker of systemic inflammation, and the amount of social media use by middle-aged adults. Study 2 (N = 228) showed that among college students CRP was prospectively associated with more social media use 6 weeks later. Providing stronger evidence of the directionality of this effect, Study 3 (N = 171) showed that in college students CRP predicted increased social media use in the subsequent week even after controlling for current week's use. Additionally, in exploratory analyses of CRP and different types of social media use in the same week, CRP was only associated with using social media for social interaction and not for other purposes (e.g., entertainment). The present research sheds light on the social effects of inflammation and highlights potential benefits of using social media as a context for studying the impact of inflammation on social motivation and behavior.

Everyday perceptions of safety and racial disparities in hair cortisol concentration.

OBJECTIVE: Black-White disparities in physiological stress during adolescence are increasingly evident but remain incompletely understood. We examine the role of real-time perceptions of safety in the context of everyday routines to gain insight into the sources of observed adolescent racial differences in chronic stress as measured by hair cortisol concentration (HCC). METHOD: We combined social survey, ecological momentary assessment (EMA), and hair cortisol data on 690 Black and White youth ages 11-17 from wave 1 of the Adolescent Health and Development in Context (AHDC) study to investigate racial differences in physiological stress. Individual-level, reliability-adjusted measures of perceived unsafety outside the home were drawn from a week-long smartphone-based EMA and tested for association with hair cortisol concentration. RESULTS: We observed a statistically significant interaction (p < .05) between race and perceptions of unsafety. For Black youth, perceived unsafety was associated with higher HCC (p < .05). We observed no evidence of an association between perceptions of safety and expected HCC for White youth. For youth who perceive their out-of-home activity locations to be consistently safe, the racial difference in expected HCC was not statistically significant. At the high end of perceived unsafety, however, Black-White differences in HCC were pronounced (0.75 standard deviations at the 95th percentile on perceived unsafety; p < .001). DISCUSSION: These findings call attention to the role of everyday perceptions of safety across non-home routine activity contexts in explaining race differences in chronic stress as assessed by hair cortisol concentrations. Future research may benefit from data on in situ experiences to capture disparities in psychological and physiological stress.

Everyday co-presence with a romantic partner is associated with lower C-reactive protein.

Social relationships are an important driver of health, and inflammation has been proposed as a key neurobiological mechanism to explain this effect. Behavioral researchers have focused on social relationship quality to further explain the association, yet recent research indicates that relationship quality may not be as robust a predictor as previously thought. Here, building on animal models of social bonds and recent theory on close relationships, we instead investigated merely being in the physical presence of one's romantic partner. Specifically, we tested the hypothesis that spending more time co-present with a loved partner in everyday life would be associated with lower C-reactive protein (CRP). Three times over the course of one month, 100 people in romantic relationships reported how much time they spent in the same physical space as their partner in the prior 24 h, in minutes, and provided a sample of blood for CRP assay (n observations = 296). Results from multi-level models showed that when one reported spending more time in the physical presence of their partner they had lower CRP - an effect that was independent from social relationship quality explanations from the prior literature, including romantic relationship quality, hostility, and loneliness. These findings move past global assessments of social isolation to consider a novel everyday behavior that is of great interest in the non-human animal literature - spending time together -- as a potential mechanism linking high-quality relationships and physical health in adult humans. The findings also point to future research on additional behavioral mechanisms that are not dependent on stress pathways: people in high-quality relationships tend to spend enjoyable and affectionate time with one another, which may impact inflammation.

Typhoid vaccine does not impact feelings of social connection or social behavior in a randomized crossover trial among middle-aged female breast cancer survivors.

BACKGROUND: Inflammation can have social consequences, which may be relevant to inflammation's link with depression. The current study tests whether a typhoid vaccine increases feelings of social disconnection and avoidance behavior. METHOD: In two full-day visits at least three weeks apart, 172 postmenopausal breast cancer survivors (Stage I-IIIA) each received a typhoid capsular polysaccharide vaccination and a saline placebo injection in a random sequence. Blood was drawn prior to the injection, as well as every 90 min thereafter for 8 h to assess the inflammatory response (interleukin-6, IL-6; interleukin-1 receptor antagonist, IL-1Ra). At both visits, women completed the Social Connection Scale at 0 and 8.5 h post-vaccination as well as implicit and explicit social avoidance tasks at 7 h post-vaccination. RESULTS: The typhoid vaccine triggered rises in both inflammatory markers (ps < 0.01), but it did not impact feelings of social connection (p = .32), or performance on the implicit (p = .34) or explicit tasks (p = .37). Inflammatory rises did not predict feelings of social connection (ps > 0.64) or performance on explicit (ps > 0.73) or implicit (ps > 0.88) social avoidance tasks. CONCLUSION: Milder inflammatory stimuli may not affect social processes. Higher levels of inflammation or, relatedly, more sickness symptoms may be necessary to recapitulate prior findings of social avoidance.

Implementation intentions to express gratitude increase daily time co-present with an intimate partner, and moderate effects of variation in CD38.

Close social connections drive mental and physical health and promote longevity. Positive, other-focused behavior like expressing gratitude may be a key mechanism for increasing close bonds. Existing evidence consistent with this claim is predominantly correlational, likely driven by challenges in causally influencing and sustaining behavior change in the context of ongoing relationships. This 5-week field experiment with daily data from couples provides the first evidence for a brief, low-cost behavioral technique to increase everyday expressed gratitude to a romantic partner. Random assignment to the gratitude expression treatment (GET) increased the amount of time couples spent co-present in everyday life, from the weeks before GET to the weeks after, relative to the control condition. This effect was mediated by the change in expressed gratitude. Voluntary co-presence is an important behavioral indicator of close bonds in non-human animals. Further analyses with a functional genotype related to the oxytocin system (rs6449182) suggest a neurochemical pathway involved in the effects of expressing gratitude. Together, this evidence bridges animal and human research on bonding behavior and sets up future experiments on biopsychosocial mechanisms linking close bonds to health.

Social Media Use and Its Link to Physical Health Indicators.

Social media use has become an integral part of many young adults' daily lives. Although much research has examined how social media use relates to psychological well-being, little is known about how it relates to physical health. To address this knowledge gap, the present research investigated how the amount of social media people use relates to various indices of physical health. Young adults provided a blood sample that was analyzed for C-reactive protein (CRP), a marker of chronic inflammation. They also completed self-report measures of social media use, somatic symptoms, illness-related physician or health center visits, and whether they sought medical care for infection-related illnesses in the last 3 months. Social media use was positively correlated with higher levels of CRP, more somatic symptoms, and more visits to the doctor or health centers for an illness. Although directionally consistent, the correlation with likelihood of seeking medical care for infection-related illnesses was nonsignificant (p = 0.061). All of these results held after controlling for factors such as sociodemographic information and depressive symptoms. Given the prevalence of social media use in daily life, these findings underscore the need for more research examining how social media use relates to physical health.

Perceived social support-giving moderates the association between social relationships and interleukin-6 levels in blood.

Although positive social relationships are assumed to relate to lower levels of chronic systemic inflammation, the empirical evidence on this association is mixed. This study examines whether perceived social support-giving (i.e., the belief that one can be available to give social support to others, henceforward referred to as perceived support-giving) moderates associations between social relationships and inflammation using data from the longitudinal follow-up of the National Survey of Midlife Development in the U.S. (MIDUS II). Middle-aged adults (N = 1054) completed self-report questionnaires on social integration, perceived support-availability from others, positive relations with others, perceived support-giving, socio-demographic information, and health-related information and provided blood samples for measurement of interleukin-6 (IL-6) as a marker of systemic inflammation. The results showed that perceived support-giving moderated the associations between IL-6 and indicators of positive social relationships, including social integration, perceived support-availability, and positive relations with others. Indicators of positive social relationships were associated with lower IL-6 among individuals higher, but not lower, in perceived support-giving. The moderating effects of perceived support-giving held after adjusting for socio-demographic and health-related covariates. Therefore, positive social relationships are associated with lower IL-6 only for individuals who believe they can give more support in those relationships. In addition, preliminary evidence indicated that the moderating effects of perceived support-giving might be further qualified by gender, being significant only in women.

Social media use and systemic inflammation: The moderating role of self-esteem.

Social media use has become an important part of social life. However, little is known about its relation to physical health. Extending prior work on social media use and psychological well-being, the present research investigated how social media use is associated with a key indicator of health, systemic inflammation. Based on research on self-esteem and work on inflammation, the current study examined whether the link between social media use and inflammatory biomarkers would be moderated by self-esteem. A nationally probablistic sample of middle-aged adults (N â€‹= â€‹863) completed self-report questionnaires on social media use, self-esteem, socio-demographic information, and health related behaviors. Approximately two years later, they provided a blood sample that was analyzed for C-reactive protein (CRP) and interleukin-6 (IL-6), biomarkers of systemic inflammation. Consistent with our hypothesis, self-esteem moderated the association between social media use and these markers of inflammation. Specifically, as self-esteem decreased, the positive association of social media use with CRP and IL-6 became stronger. These results held after controlling for socio-demographic information, health status, depressive symptoms, and medication usage. Social media use was not significantly correlated with either CRP or IL-6. The present research demonstrates physical health correlates of social media use and suggests self-esteem as a key variable that can moderate the relation between social media use and health.

Racial and Economic Adversity Differences in Stress Markers and Immune Function Among Urban Adolescents.

BACKGROUND: Exposure to racism and associated adversities, such as poverty, is hypothesized to contribute to racial inequities in health via stress and immune pathways. Furthermore, the effects of adversity may be more salient during sensitive developmental periods. Our study examined racial differences in stress and immune biomarkers during adolescence and the effects of exposure to economic adversity at distinct developmental time periods and cumulatively in accounting for potential racial differences. METHODS: Secondary analysis of the Adolescent Health and Development in Context study was conducted. Data were derived from self-administered surveys; interviews; smartphone-based, geographic-explicit ecological momentary assessment; stress biomarkers (evening salivary cortisol over six nights and hair cortisol); and immune biomarkers (salivary shedding of Epstein-Barr virus [EBV] DNA among EBV-positive adolescents). Current socioeconomic status measures included annual household income and caregiver education. Caregivers also reported experiences of bankruptcy, difficulty paying bills, receipt of food stamps/Supplemental Nutrition Assistance Program/electronic benefit transfer, and job loss when the child was of ages birth-5 years, 6-10 years, and 11 years or older. An affirmative response to any item was defined as exposure to economic adversity for that developmental time period (yes/no). A cumulative economic adversity measure was calculated as the sum of exposures across developmental periods (0 = never exposed to 3 = exposed across all time periods). Descriptive and multivariable regression analyses were conducted, accounting for covariates. RESULTS: Black/African American adolescents had higher salivary cortisol concentration, higher hair cortisol concentration, and an increased odd of salivary shedding of EBV DNA compared to White adolescents. Racial differences were not attenuated by the current socioeconomic status or economic adversity (developmental period or cumulatively). DISCUSSION: Our study provides evidence that stress and immune biomarkers differ by race as early as adolescence and may be one pathway through which racism and associated adversities contribute to racial health inequities. Further research on the contribution of multiple adversities beyond poverty to racial inequities in physiological stress and health is critical for informing effective prevention and intervention efforts.

Exposure to police-related deaths and physiological stress among urban black youth.

BACKGROUND: Emerging evidence indicates that exposure to police-related deaths is associated with negative health and wellbeing outcomes among black people. Yet, no study to date has directly examined the biological consequences of exposure to police-related deaths for urban black youth. METHODS AND FINDINGS: We employ unique data from the 2014-16 Adolescent Health and Development in Context (AHDC) study - a representative sample of youth ages 11 to 17 residing in the Columbus, OH area. A subsample of participants contributed nightly saliva samples for cortisol for up to six days, providing an opportunity to link recent exposures to police-related deaths within the residential county to physiological stress outcomes during the study period (N = 585). We examine the effect of exposure to a recent police-related death in the same county on the physiological stress (nightly cortisol) levels of black youth. We find evidence of elevated average levels of nightly cortisol (by 46%) for black boys exposed to a police-related death of a black victim in the 30 days prior to the subject's cortisol collection. We find no evidence of police-related death effects on the physiological stress levels of black girls or white youth. CONCLUSIONS: These analyses indicate that police-related deaths influence the biological functioning of black boys, with potential negative consequences for health. We consider the implications of exposure to lethal police violence among black boys for understanding racial disparities in health more broadly.

Structural and Social Determinants of Health Factors Associated with County-Level Variation in Non-Adherence to Antihypertensive Medication Treatment.

BACKGROUND: Non-adherence to antihypertensive medication treatment (AHM) is a complex health behavior with determinants that extend beyond the individual patient. The structural and social determinants of health (SDH) that predispose populations to ill health and unhealthy behaviors could be potential barriers to long-term adherence to AHM. However, the role of SDH in AHM non-adherence has been understudied. Therefore, we aimed to define and identify the SDH factors associated with non-adherence to AHM and to quantify the variation in county-level non-adherence to AHM explained by these factors. METHODS: Two cross-sectional datasets, the Centers for Disease Control and Prevention (CDC) Atlas of Heart Disease and Stroke (2014-2016 cycle) and the 2016 County Health Rankings (CHR), were linked to create an analytic dataset. Contextual SDH variables were extracted from the CDC-CHR linked dataset. County-level prevalence of AHM non-adherence, based on Medicare fee-for-service beneficiaries' claims data, was extracted from the CDC Atlas dataset. The CDC measured AHM non-adherence as the proportion of days covered (PDC) with AHM during a 365 day period for Medicare Part D beneficiaries and aggregated these measures at the county level. We applied confirmatory factor analysis (CFA) to identify the constructs of social determinants of AHM non-adherence. AHM non-adherence variation and its social determinants were measured with structural equation models. RESULTS: Among 3000 counties in the U.S., the weighted mean prevalence of AHM non-adherence (PDC < 80%) in 2015 was 25.0%, with a standard deviation (SD) of 18.8%. AHM non-adherence was directly associated with poverty/food insecurity (ß = 0.31, P-value < 0.001) and weak social supports (ß = 0.27, P-value < 0.001), but inversely with healthy built environment (ß = -0.10, P-value = 0.02). These three constructs explained one-third (R2 = 30.0%) of the variation in county-level AHM non-adherence. CONCLUSION: AHM non-adherence varies by geographical location, one-third of which is explained by contextual SDH factors including poverty/food insecurity, weak social supports and healthy built environments.

Effects of acetaminophen on risk taking.

Acetaminophen, an analgesic and antipyretic available over-the-counter and used in over 600 medicines, is one of the most consumed drugs in the USA. Recent research has suggested that acetaminophen's effects extend to the blunting of negative as well as positive affect. Because affect is a determinant of risk perception and risk taking, we tested the hypothesis that acute acetaminophen consumption (1000 mg) could influence these important judgments and decisions. In three double-blind, placebo-controlled studies, healthy young adults completed a laboratory measure of risk taking (Balloon Analog Risk Task) and in Studies 1 and 2 completed self-report measures of risk perception. Across all studies (total n = 545), acetaminophen increased risk-taking behavior. On the more affectively stimulating risk perception measure used in Study 2, acetaminophen reduced self-reported perceived risk and this reduction statistically mediated increased risk-taking behavior. These results indicate that acetaminophen can increase risk taking, which may be due to reductions in risk perceptions, particularly those that are highly affect laden.

Preliminary Evidence That CD38 Moderates the Association of Neuroticism on Amygdala-Subgenual Cingulate Connectivity.

CD38 genetic variation has been associated with autism spectrum disorders and social anxiety disorder, which may result from CD38's regulation of oxytocin secretion. Converging evidence has found that the rs3796863 A-allele contributes to increased social sensitivity compared to the CC genotype. The current study examined the moderating role of CD38 genetic variants (rs3796863 and rs6449182) that have been associated with enhanced (or reduced) social sensitivity on neural activation related to neuroticism, which is commonly elevated in individuals with social anxiety and depression. Adults (n = 72) with varying levels of social anxiety and depression provided biological samples for DNA extraction, completed a measure of neuroticism, and participated in a standardized emotion processing task (affect matching) while undergoing fMRI. A significant interaction effect was found for rs3796863 x neuroticism that predicted right amygdala-subgenual anterior cingulate cortex (sgACC) functional connectivity. Simple slopes analyses showed a positive association between neuroticism and right amygdala-sgACC connectivity among rs3796863 A-allele carriers. Findings suggest that the more socially sensitive rs3796863 A-allele may partially explain the relationship between a known risk factor (i.e. neuroticism) and promising biomarker (i.e. amygdala-sgACC connectivity) in the development and maintenance of social anxiety and depression.

A Social Analgesic? Acetaminophen (Paracetamol) Reduces Positive Empathy.

Acetaminophen - a potent physical painkiller that also reduces empathy for other people's suffering - blunts physical and social pain by reducing activation in brain areas (i.e. anterior insula and anterior cingulate) thought to be related to emotional awareness and motivation. Some neuroimaging research on positive empathy (i.e., the perception and sharing of positive affect in other people) suggests that the experience of positive empathy also recruits these paralimbic cortical brain areas. We thus hypothesized that acetaminophen may also impair affective processes related to the experience of positive empathy. We tested this hypothesis in a double-blind, placebo-controlled experiment. Specifically, we administered 1,000 mg acetaminophen or a placebo and measured effects on different measures of positive empathy while participants read scenarios about the uplifting experiences of other people. Results showed that acetaminophen reduced personal pleasure and other-directed empathic feelings in response to these scenarios. In contrast, effects on perceived positivity of the described experiences or perceived pleasure in scenario protagonists were not significant. These findings suggest that (1) acetaminophen reduces affective reactivity to other people's positive experiences and (2) the experience of physical pain and positive empathy may have a more similar neurochemical basis than previously assumed. Because the experience of positive empathy is related to prosocial behavior, our findings also raise questions about the societal impact of excessive acetaminophen consumption.