New Articles from Annals of Behavioral Medicine and Translational Behavioral Medicine

SBM's two journals, Annals of Behavioral Medicine and Translational Behavioral Medicine: Practice, Policy, Research (TBM), continuously publish online articles, many of which become available before issues are printed. Three recently published Annals and TBM articles are listed below.

SBM members who have paid their 2020 membership dues are able to access the full text of all Annals and TBM online articles via the SBM website by following the steps below.

1. Go to the Members Only section of the SBM website.
2. Log in with your username and password.
3. Click on the Journals link.
4. Click on the title of the journal which you would like to electronically access.

To check if you are a current SBM member, or if you are having trouble accessing the journals online, please contact the SBM national office at info@sbm.org or (414) 918-3156.

Annals of Behavioral Medicine

Alleviating Social Pain: A Double-Blind, Randomized, Placebo-Controlled Trial of Forgiveness and Acetaminophen

George M Slavich, Grant S Shields, Bailey D Deal, Amy Gregory, Loren L Toussaint

Background
Research has suggested that physical pain (e.g., caused by injury) and social pain (e.g., caused by social rejection) are modulated by some of the same biological systems. Consequently, it is possible that acetaminophen, which is commonly used to alleviate physical pain through neurochemical pathways, may have social pain-relieving effects that interact with forgiveness, which reduces social pain through psychological pathways. To date, however, only a few studies have examined how experiences of social pain change over time, and none have examined how acetaminophen and forgiveness interact to influence these effects.
Purpose
We addressed these issues by investigating how acetaminophen administration and daily forgiveness are associated with experiences of social pain over 21 days. We hypothesized that acetaminophen-related reductions in social pain across the 21-day study period would be greatest on days following high levels of forgiveness.
Method
To test this hypothesis, we conducted a double-blind, randomized, placebo-controlled trial in which we randomly assigned 42 healthy young adults to an acetaminophen condition (1,000 mg of acetaminophen daily), placebo-control condition (400 mg of potassium daily), or empty-control (no pill) condition. We then assessed their levels of forgiveness and social pain for 20 consecutive days.
Results
As hypothesized, acetaminophen reduced participants’ social pain levels over time but only for those exhibiting high levels of forgiveness (i.e., 18.5% reduction in social pain over 20 days).
Conclusions
These data are the first to show that forgiveness and acetaminophen have interactive effects on experiences of social pain, which is one of the most common and impactful of all human experiences.

Setting Realistic Health Goals: Antecedents and Consequences

Aya Avishai, Mark Conner, Paschal Sheeran

Background
People often fail to translate their intentions into health behaviors.
Purpose
The present research examined a new potential moderator of intention–behavior relations, namely, how realistic or unrealistic are respective goal intentions. Goal realism was defined as the degree to which intentions are aligned with expectations (i.e., predicted performance).
Methods
A validation study (N = 81) examined our novel goal realism measure. Study 1 (N = 246) tested goal importance, fantasy proneness, and pathways thinking as predictors of realistic goal setting using a cross-sectional questionnaire design. Moderation of the intention–behavior relation was tested in prospective surveys of cervical cancer screening (Study 2, N = 854), physical activity (Study 3, N = 237), and performance of a suite of 15 health behaviors (Study 4, N = 378).
Results
The validation study offered preliminary evidence concerning the convergent and predictive validity of the goal realism measure. Study 1 showed that goal importance, fantasy proneness, and pathways thinking interacted to predict how realistic were intentions to perform 11 health behaviors. In Study 2, realistic intentions better predicted women’s attendance for cervical cancer screening compared with unrealistic intentions. Study 3 confirmed this finding for a frequently performed behavior (physical activity). In Study 4, multilevel modeling of longitudinal data for 15 health behaviors again revealed a significant goal realism × intention interaction. Greater realism was associated with improved prediction of behavior by intention. The interaction term remained significant even when past behavior, perceived behavioral control, and other predictors were taken into account.
Conclusions
The present findings offer new insights into the factors that lead to more realistic intentions and demonstrate that goal realism influences how effectively intentions are translated into action.

Ambivalence in the Early Years of Marriage: Impact on Ambulatory Blood Pressure and Relationship Processes

Wendy C Birmingham, Lori L Wadsworth, Man Hung, Wei Li, Raphael M Herr

Background
Marriage is associated with lower cardiovascular morbidity and mortality, but quality matters. Marriages characterized by ambivalent behaviors (containing both highly positive and highly negative behaviors concurrently) may not confer the same cardiovascular benefits as characterized by purely positive behavior. Ambivalence is assumed to take time to develop but couples in the early years of marriage may already exhibit ambivalent behaviors and thus be at increased risk for future cardiovascular events.
Purpose
The purpose of this study was to determine the frequency of spouse and own ambivalent behavior, the impact on interpersonal (i.e., responsiveness, disclosure, affective interactions) processes, and ambulatory blood pressure (ABP) in individuals in the early years of marriage.
Methods
In 84 young married couples, objective and subjective ambivalence, interpersonal functioning, and ABP over a 24-hr period were assessed.
Results
As predicted, ambivalence developed early in marriage. Regarding interpersonal processes, spousal and own objective ambivalent behavior was associated with lower spousal responsiveness (p < .01), disclosure (p < .05), and more negative (p < .03) and less positive interactions (p < .001). Physiologically, ambivalent spousal behavior was associated with higher systolic blood pressure (p = .02) and higher diastolic blood pressure (p = .04). Measures of subjective ambivalence were congruent.
Conclusions
Early marriages already contain ambivalent behavior; in such cases, individuals may not receive the cardiovascular protection of a supportive marriage.

 

Translational Behavioral Medicine

Advancing science and practice using immersive virtual reality: what behavioral medicine has to offer

Susan Persky, Megan A Lewis

Abstract
Interest in immersive virtual reality (VR) technologies is burgeoning as the hardware becomes less costly and more accessible to users, including researchers and practitioners. This commentary outlines the field of immersive VR and highlights applications of its use relevant to translational behavioral medicine. We describe the challenges facing VR applications for health and medicine, and how the core strengths of behavioral medicine can advance theory, research, and practice using VR. By highlighting potential uses of immersive VR alongside the challenges facing the field, we hope to inspire researchers to apply robust theories, methods, and frameworks to generate stronger evidence about the feasibility, acceptability, efficacy, and effectiveness of using this technology in translational behavioral medicine.

A glossary of user-centered design strategies for implementation experts

Alex R Dopp, Kathryn E Parisi, Sean A Munson, Aaron R Lyon

Abstract
User-centered design (UCD), a discipline that seeks to ground the design of an innovation in information about the people who will ultimately use that innovation, has great potential to improve the translation of evidence-based practices from behavioral medicine research for implementation in health care settings. UCD is a diverse, innovative field that remains highly variable in terms of language and approaches. Ultimately, we produced a glossary of UCD-related strategies specifically for experts in implementation research and practice, with the goal of promoting interdisciplinary collaboration in implementation efforts. We conducted a focused literature review to identify key concepts and specific strategies of UCD to translate into the implementation field. We also categorized the strategies as primarily targeting one or more levels of the implementation process (i.e., interventions, individuals, inner context, and outer context). Ultimately, we produced a glossary of 30 UCD strategies for implementation experts. Each glossary term is accompanied by a short, yet comprehensive, definition. The strategies and their definitions are illustrated, using a hypothetical behavioral medicine intervention as an example, for each of the four levels of the implementation process. This UCD glossary may prove useful to implementation experts who wish to develop effective collaborations and “shared language” with UCD experts to enhance use of behavioral medicine research in health services. Directions for future research are also discussed.

A computational study of mental health awareness campaigns on social media

Koustuv Saha, John Torous, Sindhu Kiranmai Ernala, Conor Rizuto, Amanda Stafford, Munmun De Choudhury

Abstract
As public discourse continues to progress online, it is important for mental health advocates, public health officials, and other curious parties and stakeholders, ranging from researchers, to those affected by the issue, to be aware of the advancing new mediums in which the public can share content ranging from useful resources and self-help tips to personal struggles with respect to both illness and its stigmatization. A better understanding of this new public discourse on mental health, often framed as social media campaigns, can help perpetuate the allocation of sparse mental health resources, the need for educational awareness, and the usefulness of community, with an opportunity to reach those seeking help at the right moment. The objective of this study was to understand the nature of and engagement around mental health content shared on mental health campaigns, specifically #MyTipsForMentalHealth on Twitter around World Mental Health Awareness Day in 2017. We collected 14,217 Twitter posts from 10,805 unique users between September and October 2017 that contained the hashtag #MyTipsForMentalHealth. With the involvement of domain experts, we hand-labeled 700 posts and categorized them as (a) Fact, (b) Stigmatizing, (c) Inspirational, (d) Medical/Clinical Tip, (e) Resource Related, (f) Lifestyle or Social Tip or Personal View, and (g) Off Topic. After creating a “seed” machine learning classifier, we used both unsupervised and semi supervised methods to classify posts into the various expert identified topical categories. We also performed a content analysis to understand how information on different topics spread through social networks. Our support vector machine classification algorithm achieved a mean cross-validation accuracy of 0.81 and accuracy of 0.64 on unseen data. We found that inspirational Twitter posts were the most spread with a mean of 4.17 retweets, and stigmatizing content was second with a mean of 3.66 retweets. Classification of social media–related mental health interactions offers valuable insights on public sentiment as well as a window into the evolving world of online self-help and the varied resources within. Our results suggest an important role for social media–based peer support to not only guide information seekers to useful content and local resources but also illuminate the socially-insular aspects of stigmatization. However, our results also reflect the challenges of quantifying the heterogeneity of mental health content on social media and the need for novel machine learning methods customized to the challenges of the field.