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Health psychology annotated readings, article reviews

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Annotated readings of health psychology journal articles.

Annotated readings of health psychology journal articles.

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    Health psychology annotated readings, article reviews Health psychology annotated readings, article reviews Document Transcript

    • HEALTH PSYCHOLOGYANNOTATED READINGS Westerberg, VM 2011
    • Westerberg, VM Page 2 of 81TABLE OF CONTENTS1.- ANNOTATED READINGS 2 1.1.- ANNOTATION I 2 1.2.- ANNOTATION II 3 1.3.- ANNOTATION III 4 1.4.- ANNOTATION IV 5 1.5.- ANNOTATION V 6 1.6.- ANNOTATION VI 7 1.7.- ANNOTATION VII 8 1.8.- ANNOTATION VIII 9 1.9.- ANNOTATION IX 10 1.10.- ANNOTATION X 11 1.11.- ANNOTATION XI 122.- REFERENCES 133.- APPENDICES 153.1.- APPENDIX 1: ANNOTATION I JOURNAL ARTICLE 163.2.- APPENDIX 2: ANNOTATION II JOURNAL ARTICLE 253.3.- APPENDIX 3: ANNOTATION III JOURNAL ARTICLE 293.4.- APPENDIX 4: ANNOTATION IV JOURNAL ARTICLE 333.5.- APPENDIX 5: ANNOTATION V JOURNAL ARTICLE 373.6.- APPENDIX 6: ANNOTATION VI JOURNAL ARTICLE 413.7.- APPENDIX 7: ANNOTATION VII JOURNAL ARTICLE 493.8.- APPENDIX 8: ANNOTATION VIII JOURNAL ARTICLE 553.9.- APPENDIX 9: ANNOTATION IX JOURNAL ARTICLE 623.10.- APPENDIX 10: ANNOTATION X JOURNAL ARTICLE 703.11.- APPENDIX 11 : ANNOTATION XI JOURNAL ARTICLE 77
    • Westerberg, VM Page 3 of 811.- ANNOTATED READINGS1.1.- ANNOTATION IDettling, A.C., Parker, S.W., Lane, S., Sebanc, A., & Gunnar, M.R. (2000). Quality of care and temperament determine changes in cortisol concentrations over the day for young children in childcare. Psychoneuroendocrinology, 25 (8), 819-836. doi:10.1016/S0306- 4530(00)00028-7The current study was carried out by a young group of American and Swiss Psychology graduateswho put their grants together to fund their research, a work which, up to date, has been cited in 88studies, but not always as a study reference.The authors investigated whether patterns of cortisol secretion in a small sample of 21 highsocioeconomic class preschool children in group versus home care were influenced by quality ofattention and stimulation from the childcare provider, and if temperament (negative affectivity andlow effortful control) and separation from parents influenced this relationship. To measure theirconstructs, they shortened well-known psychometric tests, but their complicated statistical analysismakes it difficult to replicate this test.Their results align with those of previous studies, that is, that young children are sensitive to socialcontext and that this is mediated by temperament. However, the internal validity of this study shouldbe questioned on the basis that they used a non-randomized, non-matched convenience sample (anylower socioeconomic class, ethnic minority, or single-parent children?), they manipulatedquestionnaires, the tests and samples were taken by parents, compliance could not be guaranteed,the samples were mailed days after collection and researchers replaced missing samples with themedia of the existing samples.Significantly, and most certainly for ethical reasons, childcare providers were assessed forcompetence but parents were not, making it difficult to predict whether the lack of stress, measuredas the expected circadian pattern of cortisol levels, shown by children in quality childcare actuallyreflects separation relief instead of care benefits. The results of this study correlate with those ofUrizar and Muñoz (2011), White-Traut et al (2009), and Pawlow and Jones (2002) in that anenhanced environment and quality of care have measurable biological outcomes influencing overallhealth.Further research should consider increasing the power of the study with a larger, representativesample, an improved internal validity as detailed above, generalization across participants(socioeconomic class, age, culture) and across operational definitions (results show that an enhancedenvironment decrease stress, but not how a deprived one influences it), and an ethical but realisticapproach to the effect of family context in children’s biological, psychological and social health.
    • Westerberg, VM Page 4 of 811.2.- ANNOTATION IIDowd, J.B., Ranjit, N., Phuong Do, D., Young, E.A., House, J.S, & Kaplan, G.A. (2011). Education and levels of salivary cortisol over the day in US adults. Annals of Behavioral Medicine, 41 (1), 13-20. doi: 10.1007/s12160-010-9224-2This cross-sectional study was carried out in the city of Chicago (IL) by experts in Public Health,Demographics, Psychiatry, Sociology and Epidemiology. It was funded by two grants from theNational Institute of Child Health and Human Development. The aim was to elucidate the biologicalmechanisms linking socioeconomic status (SES) (measured as low [<12yrs] education), and cortisollevels in view of the inconsistent and even contradictory previous research. This is the first study totake into account the pulsatile circadian secretion of cortisol, which requires multiple measures overseveral days and specific data analysis. They used multi-level modelling and non-parametric splinetechnique for that purpose, and constitute major strengths of this work.With regard to the measure of SES, the authors, quite rightly, considered that low educationdetermines lower grade employment and that it is the best available parameter of lifelong SES, betterthan income.Researchers stated that the discrepancies in the literature on the relationship between SES andcortisol stem from inconsistencies in participants’ compliance, sample collection, data analysis, intra-individual cortisol secretion patterns and beliefs relating SES, chronic illness and cortisol secretion.With the risk of the above inconsistencies in mind among others, most of the previous research hadtheorised and shown that given that cortisol is “the stress hormone”, longstanding hardshipassociated with a low SES would evidence higher morning, evening and baseline levels. Additionally,it was believed that only higher-than-normal cortisol levels led to poor health outcomes.The current study aligns with, and confirms, the results obtained by Brandtstadter et al in Germanyin 1991, which are that excessive chronic exposure to cortisol (as biological marker) or to stress (asa sociopsychological marker) leads to tolerance and to a permanently blunted response by thesecreting organ-system, the HPA axis. Additionally, the authors evidenced that both high and lowcortisol levels are damaging to health, something that had been suggested in just one previous study,that by Brandtstadter et al (1991).Further longitudinal research in this line is warranted to better outline how much/little cortisol andhow long an exposure to it are required to cause HPA axis blunting and to characterize stress-relatedhealth conditions prior and after that point. Moreover, further clarification of the biopsychosocialmarkers and mechanisms linking SES and health outcomes is required to build up knowledge thatcould potentially turn into the development and implementation of sustainable health promotionstrategies.
    • Westerberg, VM Page 5 of 811.3.- ANNOTATION IIIHammerfald, K., Eberle, C., Grau, M., Kinsperger, A., Zimmermann, A., Ehlert, U., & Gaab, J. (2006). Persistent effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects — A randomized controlled trial. Psychoneuroendocrinology, 31 (3), 333-339. doi:10.1016/j.psyneuen.2005.08.007The study was conducted by a research group of German and Swiss scholars as the continuation of aseries of previous assays of this group on the topic of psychosocial stress management. This timethey aimed to examine the long-term effects and generalisability of cognitive-behavioural stressmanagement (CBSM) training on cortisol stress responses in healthy undergraduate men andwomen who had previously taken a stress-inducing test, the Trier Social Stress Test (TSST).Findings in this detailed study showed that the previously reported attenuation of cortisol stressresponses through CBSM persisted for at least 4 months after the intervention and did so similarly inboth genders. No prior literature could be found demonstrating persistence of endocrine effects ofCBSM, therefore, results would be ground-breaking if further research replicates results consideringlimitations and further increasing the power of the study (larger sample, tighter control ofextraneous variables, further controlling error variance, increase treatment effect).The authors are among the pioneers who acknowledge that both persistently high and persistentlylow levels of cortisol have health outcomes implications. All previous studies had only focused on theimpact of high cortisol effects on health. This research shows that it is the disturbance ofhomeostasis that is accountable for disease, no matter in which direction the alteration goes, up ordown, provided that it is maintained for a long period of time. Further research should be directedtowards determining “how long is too long” an exposure to cortisol imbalance and if high and lowlevels have different health implications.The findings of Hammerfald et al (2006) align with those of Wrosch et al (2007) in that bothresearch groups found cortisol to be the main mediator of allostatic load (burden of persistent highlevels of cortisol) which leads to increased mortality and decreased cognitive and physicalfunctioning in the elderly. Further research with functional MRI should address which cerebral areasare more sensitive to the wear-and-tear effects of cortisol and factor which determine itsprogression.The authors suggested that given that stress-induced alterations of the functionality of the HPA axisare known to be involved in the onset and maintenance of both somatic and psychologicalconditions, CBSM or similar interventions could be used for prevention and treatment of detrimentalstress effects. But then again, the translation of reliably-replicated effective studies like this one intoa clinical or social context may take many years. The question is: who should be responsible for theimplementation of such research?
    • Westerberg, VM Page 6 of 811.4.- ANNOTATION IVHeaney, J. L., Ginty, A.T., Carroll, D., & Phillips, A.C. (2011). Preliminary evidence that exercise dependence is associated with blunted cardiac and cortisol reactions to acute psychological stress. International Journal of Psychophysiology, 79 (2), 323-32. doi:10.1016/j.ijpsycho.2010.11.010This study was conducted by two influential British scholars, Douglas Carroll and Anna Phillips, andtheir respective female doctoral students. It took place on the premises of the School of Sport andExercise Sciences of the University of Birmingham and was funded by the Department of Education.Heaney et al (2011) approached addiction and its consequences from a dubious psychophysiologicalperspective, theorising and concluding that just like smoking and tobacco, exercise dependencecauses blunted cardiovascular and cortisol reactions to acute psychological stress, the result ofwhich is far from benign according to the authors, leading to motivational dysregulation.This study exemplifies bias. First, although many researchers use convenience samples, likeundergraduate students, this one was comprised of exclusively Caucasian undergraduate women,with only one exception (an Indian woman). The reason given is that “exercise dependence isreasonably well characterized in women and is rarer in men” (Heaney et al, 2011), citing a formerUniversity of Birmingham PhD student as a reference. Second, they based their research mainly on amade-to-order, non-revised scale they called Exercise Attitudes and Beliefs Questionnaire (EABQ)and on the Exercise Dependence Questionnaire (EDQ).The EABQ scale cannot even be critiqued because no mention is made or link is offered to thedevelopment of the test, like how did they design factor analysis, how did they determine face andunderlying dimensions of data, how did they manage data clustering sorting, and more importantly,where are the validity and reliability analyses?. The EDQ scale is a more widely used test with justenough construct validity flaws to render it useless in this context, as items assess mainly attitudesand social aspects of exercise instead of dependence (Hausenblas & Symons-Downs, 2002), there isno set cut-off point, it measures far more secondary than primary exercise dependence, it does notdisqualify participants with eating disorders (bulimia and anorexia), it fails to measure tolerance andlack of control, and, despite its name, the EDQ has only been validated against the EAT (EatingAttitudes Test) and POMS (Profile of Mood States) (Ogden, Veale, & Summers, 1997) .Finally, this article raises issues worth exploring: Why was a design, observer, measurement,sampling, and procedurally biased study allowed to be run and published? How do studies like thesecontribute to health promotion? Note for the Quality Control Departments of the University ofBirmingham and the International Journal of Psychophysiology (peer reviewers): anybody home?
    • Westerberg, VM Page 7 of 811.5.- ANNOTATION VLam, S., Dickerson, S.S., Zoccola, P.M., & Zaldivar, F. (2009). Emotion regulation and cortisol reactivity to a social-evaluative speech task. Psychoneurendocrinology, 34 (9), 1355- 1362. doi:10.1016/j.psyneuen.2009.04.006This multicultural group of California-based scholars dedicated to psychosocial research, aimed tocover a gap in literature regarding trait forms of emotion regulation and cortisol responses in arealistic social context. Lam et al (2009) suggest that it is possible to predict cortisol reactivity to anacute stressor and that this can be moderated by emotion regulation strategies, like suppression andreappraisal (SA).Previous laboratory studies had found a relationship between emotion regulation strategies such asrepressive coping, emotional intelligence, suppression, reappraisal and cardiovascular reactivity, buta biological marker, like cortisol, had never been used to quantify or predict cortisol reactivity tostress. Additionally, previous studies had shown no mundane realism as they had all used non-socialemotion induction techniques (watching videos, pictures, cards). Here, the authors employed asocial-evaluative speech task in the form of a modified version of the Trier Social Stress Test (TSST),and suppression and reappraisal were assessed with the Emotion Regulation Questionnaire (ERQ).The study showed that suppression and reappraisal, both independently and combined, predictedexaggerated cortisol responses to the speech task. Significance of results is enhanced by the fact thatLam et al (2009) controlled for the effects of trait and state anxiety, health conditions, medication,diet, exercise, and demographic variables. With regard to demographics, this study is relevant for theNew Zealand Maori population in that the majority of participants (>52%) were Asia-Pacificislanders.Limitations of the current study are those of the participants’ characteristics, which raise questionsabout generalisation: Can results be generalised across age-groups (undergraduate-other), acrossethnicities (Asia-Pacific-other), across socioeconomic positions (high-low) and across personalitytypes?Possible questions that future research could address are: Does negative emotion regulation ofstressful situations through suppression and appraisal require effortful processing, enhancedattention and/or self control? Can negative emotion regulation be generalised to the management ofother stressors different from social interaction? Do suppression and re-appraisal enhance socialinteraction, and if so, what effect does it have on behaviour, bodily processes and health outcomes?What are the consequences of persistent negative emotion regulation on social, psychological andphysical outcomes?
    • Westerberg, VM Page 8 of 811.6.- ANNOTATION VIPawlow, L.A., & Jones., G.E. (2002). The impact of abbreviated progressive muscle relaxation on salivary cortisol Biological Psychology, 60 (1), 1-16. doi:10.1016/S0301-0511(02) 00010-8The current study was carried out by a PhD student and her supervisor of the University of SouthernMississippi. The source of funding was not mentioned and could not be found.In this study, Pawlow and Jones (2002) matched and randomised sample participants on thevariables of age and sex, but no reference was made to ethnicity, nationality, or socioeconomic class.Likewise, they did not control for participants’ conditions that could potentially influence the twobiological variables used to show stress management, that is heart rate and finger pulse volume, likeprevious habits (smoking, exercising), diet or personality types.They claim that given that results evidenced significant behavioural manipulation of thehypothalamus-pituitary axis (HPA), the doors to further research on immune-enhancement, as aconsequence of the endocrinological change are opened. However, knowing that maintained highlevels of cortisol have detrimental effects on the immune system does not mean that the oppositesituation, that is, that lower levels of cortisol would enhance immune function, and this warrantsfurther research in this line.Additionally, further research may include meta-analyses. The present study could be comparedwith related ones, like that by Healey et al (2011) on exercise and stress, to show if or how thedegree of muscular activity relates to cortisol levels and health outcomes. However, only Pawlow andJones (2002) produced a sound, well-structured, relevant psychobiological research with particularemphasis on avoiding the internal validity problems noted in the related literature, which isparticularly remarkable in Heaney et al (2011), but which did not keep it from being published in theprestigious International Journal of Psychophysiology.The authors concluded that “the implications for possible uses of relaxation as an inexpensive,effective means of improving people’s health are enormous” (Pawlow & Jones, 2002). However, theyface the same barriers as fellow American researchers Urizar and Muñoz (2011) in that the UnitedStates’ social policy is not a world reference. It is quite discouraging that the translation of effectivestudies like these into sustainable clinical and patient-service improvements, if it ever happens, maytake up to 20 years according to the U.S. Department of Health and Human Services (2011). Thisremains a substantial obstacle to the improvement of healthcare, which is necessary for theelimination of health disparities that disproportionately affect population minorities. Maybe ifresearch institutions, like universities, took the initiative and, for example, established academic-based health centres, a small but firm forward step would be taken in the direction of healthpromotion.
    • Westerberg, VM Page 9 of 811.7.- ANNOTATION VIIReeve, J., & Tseng, C.M.. (2011). Cortisol reactivity to a teachers motivating style: the biology of being controlled versus supporting autonomy. Motivation and Emotion, 35 (1), 63-74 doi: 10.1007/s11031-011-9204-2The present study was funded by the Korean Department of Education and carried out by a Seoul-based American scholar and researcher and a Korean Iowa University PhD student in the Universityof Iowa premises. The authors built up on the extensive prior work of Dr Reeve on psychosocialmotivators, but this time the aim was to link motivational styles (controlling, supportive, neutral)with salivary cortisol levels and positive functioning using the Controlling Teacher Scale (CTS), theLearning Climate Questionnaire (LCQ), SOMA cubes (“soma” is not an acronym), the Perceived Self-Determination scale (PSD), and the Active Feelings States (AFS). The two latter measures weredeveloped by Prof Reeve 10 and 15 years ago respectively and have been widely used since then.The authors hypothesised and further found a significant relationship between interpersonal eventresponse and cortisol reactivity. Using repeated-measures mixed ANCOVA analyses, they concludedthat now that they have confirmed their hypothesis, the study should be replicated by another studygroup. Actually, one study could hardly be said to confirm any results. Even after multiple power-enhanced replications and/or a longitudinal study, researchers would still phrase their conclusionsin a more cautious fashion, especially when the study limitations have not been mentioned. Thisraises a few questions about the reliability of the study: How reliable and independent are Korean-funded researches? Would the Korean authorities have been satisfied if non-conclusive results hadbeen found, getting no return for investment? How eager (and pressed) were the researchers toprove their hypothesis?Indeed, further research is required to see if findings can be replicated in another context, with alarger sample and with male and female teachers, to see what the long-term consequences of bothcontrolling and motivational teaching are (longitudinal studies) in terms of academic and evenpersonal and professional achievements, and to see what the long-term health outcomes of childrenin either group are.Motivational teaching has become the golden standard in Western countries as evidence-basedresearch and common sense indicate that outcomes are far better for the biopsychosocial health ofchildren. However, in developing countries and in those with dictatorial regimes, where controllingstyles can be theorized to prevail, the results of this research could have an impact on policy makers,who would not see it as a Western imposition but as their own initiative to move on to a, literally,more relaxed teaching style.
    • Westerberg, VM Page 10 of 811.8.- ANNOTATION VIIITartaro, J., Luecken, L.J., & Gunn, H.E. (2005). Exploring heart and soul: Effects of religiosity/spirituality and gender on blood pressure and cortisol stress responses. Journal of Health Psychology, 10 (6), 753-766doi: 10.1177/1359105305057311This study was carried out by three Arizona University Health Psychology researchers based onprevious literature linking positive psychobiological health outcomes with religiousness/spirituality(RS). Their novel contribution is that for the first time, a biological marker of stress (cortisol) wasobtained to demonstrate those benefits.Previous work linked the effects of RS to cardiovascular and immune system function enhancementwhich was suggested to explain reduced overall mortality of individuals involved in RS practicesregardless of degree of public or private commitment and of depth of belief. Benefits were found tobe independent of socioeconomic position, culture, ethnicity, age and sex. The present studysubstantiates those results and suggests additional mechanisms by which RS may contribute tohealth improvement, like the enhancement of social and coping resources, and the promotion ofhealthy behaviours like forgiveness and of positive emotions like hope. A further positive emotion tobe considered would be meaning in life.The RS construct was measured using the Brief Multidimensional Measurement of Religiousness /Spirituality (BMMRS). Two possible flaws of this tool, and therefore of the study are: First, that theBMMRS may not be culturally sensitive, based on the non-significant results observed for meditationon cortisol levels. The current sample characteristics are those of the typical Western society: MostlyChristian Caucasians. Meditation, instead, is characteristic of Eastern societies where Buddhism andHinduism predominate. Second, the way items exploring meditation are phrased in the BMMRS, like:“Within your RS traditions, how often do you meditate?”. Christianism, Judaism and Islamrecommend evaluating one’s conduct to ensure better eternal-life outcomes, whereas Buddhism andHinduism prescribe meditation to attain enlightening to ensure better re-incarnation outcomes (LaFave, 2004).It is doubtful that further research with either a revised culturally sensitive version of the BMMS orwith another questionnaire would make a difference in the mediation-cortisol levels relationshipresults of this study because respondents’ characteristics would be similar in the same context.However, it would be enlightening to conduct a similar research with an adapted questionnaire in atraditionally Budhist or Hinduist country to see how the subset of meditation influences therelationship RS - health outcomes. This work is another step forward towards the demonstrationthat psychology, that is, thoughts, behaviours and beliefs, influences biology at least as much asbiology influences psychology. The relationship is a two-way road. Destination: Healthier State.
    • Westerberg, VM Page 11 of 811.9.- ANNOTATION IXUrizar, G.G., & Muñoz, R.F. (in press). Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants. Psychoneuroendocrinology. doi:10.1016/j.psyneuen.2011.04.002Urizar and Muñoz are two California-based Hispanic Clinical Psychology professors and researcherswho funded this study with grants from their own PhD grants and others coming from national andprivate sources. Their field of interest is a cross-cultural biopsychosocial perspective of materno-filial conditions associated with stress and their psychosocial management.This comprehensive, well-structured article describes their innovative research of pregnant, lowsocioeconomic status, Hispanic women who volunteered to be taught cognitive-behavioural stressmanagement (CBSM) techniques at least 12 weeks pre-partum. Although their results showed thatthe intervention was effective in reducing cortisol and self-reported stress levels among mothers andchildren for up to 18 months post-partum, parenting responsibilities and socioeconomic problemsnullified the effects of the therapy after that time. It was also noted that the effects were larger andmore long-lasting in younger, more inexperienced mothers.This pilot study has a few limitations which should be addressed in further research like howprevious history of depression may be predictive of poorer CBSM outcomes, how to improve internalvalidity even further by avoiding threats like drop-outs (18% in this study) and non-compliance,how to improve external validity evaluating generalisation across age-groups, socioeconomic classesand cultures. For that purpose, findings in this study could be related to those of White-Traut et al(2009), Dettling et al (2000) and Pawlow and Jones (2002) in that behavioural modification havemeasurable biological consequences, some of which irreversible.It would be interesting to conduct further longitudinal research of participants, should thisintervention be adopted in a community health centre. It should not be very difficult in terms ofhuman and material requirements as the intervention could be run in pre-existing midwife offices orin the maternity department of a hospital or clinic by doctoral fellows or advanced doctoral studentswho could do it at no charge provided they were allowed to use the results for their study.CBSM is an easy, inexpensive, effective, contraindications-free therapy, and therefore, probablydoomed, as interventions that provide benefits (health improvement) to deprived, underservedpopulations, but no benefits (revenue) to institutions are difficult to implement, especially in thecontext of a hard-core neoliberal country like the USA, where social policies leave a lot to be desired.
    • Westerberg, VM Page 12 of 811.10.- ANNOTATION XWhite-Traut, R.C., Schwertz, D., McFarlin, B., & Kogan, J. (2009). Salivary cortisol and behavioral state responses of healthy newborn infants to tactile-only and multisensory interventions. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38 (1), 22–34 doi: 10.1111/j.1552-6909.2008.00307.xThe current study is the result of a multi-disciplinary collaboration of four professors and researchspecialists of the Illinois College of Nursing based on previous animal and human sensoryintervention studies to prevent stress and its implications on health outcomes. Here, the authorswanted to test if there is any difference between a tactile-only and multisensory approach tonewborn stress control and how the difference, if any, would translate into cortisol levels.Results showed that any degree of tactile stimulation is distressing for newborn children as shownby an increase in cortisol levels, whereas the application of a multisensory auditory, tactile, visualand vestibular (ATVV) intervention resulted in a significant but short-lived decrease in cortisollevels. Salivary cortisol is considered an acceptable measure of human stress reactivity across ages;however, additional measures, apart from crying, that reliably quantify infant stress reactivity areneeded.The article presentation and analysis are reader friendly, directed towards an academic audienceinterested in psychobiology, that is, how psychology influences biology as opposed to biopsychologyor how biology affects psychology. The study was well-designed and efforts were done towards agood level of internal validity, like sample matching and randomization, control for modifiers(maternal, gestational and infant age, sex, race), extraneous variables (epidural anaesthesia, deliverymode, medication, maternal and infant health status, separation anxiety, feeding mode and time).Reliability was shown demonstrating an inter-rater agreement greater than 88%.Limitations of this study were small saliva sample volumes and loses (contamination), lack ofoptimization of saliva collection times in an age-group where the HPA is undergoing development,lack of research and understanding of the underlying mechanisms of the complex relationshipbetween the biological parameter (cortisol levels) and the result (organ-system reaction) of stress ininfants (how do hippocampal glucocorticoid cell receptors vary? [in number?, in reactivity?] ), how isgene expression altered by behaviour or by environmental characteristics?).Further research with a larger sample addressing the above limitations would be needed to replicatethese findings and to further evaluate the relationship between behavioural state and cortisol level.Additionally, research is warranted to document whether the ATVV intervention reduces cortisollevels, how long lasting ATVV effects are, how long-term administration might influence cortisollevels, and whether the interventions are beneficial for other populations.
    • Westerberg, VM Page 13 of 811.11.- ANNOTATION XIWrosch, C., Schulz, R., Miller, G.E., Lupien, S., & Dunne, E. (2007). Physical health problems, depressive mood, and cortisol secretion in old age: Buffer effects of health engagement control strategies. Health Psychology, 26 (3), 341-349. doi: 10.1037/0278- 6133.26.3.341The authors of this article have been doing research on the topic of health engagement psychologicalstrategies for over 10 years now. They are well known Canadian Psychology scholars who fund theirresearch from different national Canadian and independent institutions. Their articles have beenpublished in the major Health Psychology journals.This is the fourth work of this prolific group of researchers, which is based both on their previousstudies and on the most recent related literature, usually not older than 10 years. To date, this articlehas been used as a reference in 18 related works, from books to peer reviewed and journal articles.In this cross-sectional study, the authors aimed to further evaluate the role of control behaviours inphysical health improvement in a large sample of senior citizens from a biopsychosocial perspective.They used Health Engagement Control Strategies (HECS) to examine the associations between olderadults physical health problems, depressive mood, and diurnal cortisol secretion. They usedcommon, simple, well-known self-reported measures of the variables involved. Results showed thatdepressive mood completely mediated the HECS buffer effects on the association between physicalhealth problems and cortisol secretion. Findings were more significant among women and youngerindividuals.Wrosch et al (2007) offer a sound work evidencing that psychological mechanisms and interventionsaffect biological health parameters, and they conclude that the results of this and related studiescontribute to show that effective psychological management of physical stressors can prevent thenegative effects on psychological, biological and physical health of individuals as they age. The nextstep could be the implementation and evaluation of this strategy in a community health centre.However, although the authors controlled for neuroticism, they consistently failed to mention andthen consider how the predominant personality traits of the participants, namely conscienciousnessand extraversion, could be relevant confounds accountable for at least part of the results found.Further research, preferably a large-scale longitudinal study, should take into account this issue andconsider others like sample matching (no reference is made to ethnicity, of much relevance incountries like Canada and New Zealand), possible confounds like concurrent use of medication, sleeppattern, and Hawthorne and placebo effects. Further research in the form of meta-analyses forexternal validity evaluation, like generalization across age-groups of stress managementintervention effects, could compare this study with those by Urizar and Muñoz (2011) and White-Traut et al (2009).
    • Westerberg, VM Page 14 of 812.- REFERENCESBrandtstadter J., Baltes-Gotz B., Kirschbaurn C., Helihammer D. (1991). Developmental and personality correlates of adrenocortical activity as indexed by salivary cortisol: Observations in the age range of35 to 65 years. Journal of Psychosomatic Research, 35, 173-185.Dettling, A.C., Parker, S.W., Lane, S., Sebanc, A., & Gunnar, M.R. (2000). Quality of care and temperament determine changes in cortisol concentrations over the day for young children in childcare. Psychoneuroendocrinology, 25 (8), 819-836. doi:10.1016/S0306-4530(00)00028-7Dowd, J.B., Ranjit, N., Phuong Do, D., Young, E.A., House, J.S, & Kaplan, G.A. (2011). Education and levels of salivary cortisol over the day in US adults. Annals of Behavioral Medicine, 41 (1), 13- 20. doi: 10.1007/s12160-010-9224-2Hammerfald, K., Eberle, C., Grau, M., Kinsperger, A., Zimmermann, A., Ehlert, U., & Gaab, J. (2006). Persistent effects of cognitive-behavioral stress management on cortisol responses to acute stress in healthy subjects — A randomized controlled trial. Psychoneuroendocrinology, 31 (3), 333-339. doi:10.1016/j.psyneuen.2005.08.007Hausenblas, H., & Symons-Downs, D. (2002). Exercise dependence: a systematic review. Psychology of Sport and Exercise, 3 (2), 89-123.Heaney, J.L., Ginty, A.T., Carroll, D., & Phillips, A.C. (2011). Preliminary evidence that exercise dependence is associated with blunted cardiac and cortisol reactions to acute psychological stress. International Journal of Psychophysiology, 79 (2), 323-32. doi:10.1016/j.ijpsycho. 2010.11.010La Fave, S. (2004). Comparing Eastern and Western Religions. Saratoga, CA: West Valley College Publishing.Lam, S., Dickerson, S.S., Zoccola, P.M., & Zaldivar, F. (2009). Emotion regulation and cortisol reactivity to a social-evaluative speech task. Psychoneurendocrinology, 34 (9), 1355-1362. doi:10.1016/j.psyneuen.2009.04.006Ogden, J., Veale, D., & Summers, Z. (1997). The development and validation of the exercise dependence questionnaire. Addiction Research, 5 (4), 343-356.Pawlow, L.A., & Jones., G.E. (2002). The impact of abbreviated progressive muscle relaxation on salivary cortisol. Biological Psychology, 60 (1), 1-16. doi:10.1016/S0301-0511(02) 00010-8Reeve, J., & Tseng, C.M.. (2011). Cortisol reactivity to a teachers motivating style: The biology of being controlled versus supporting autonomy. Motivation and Emotion, 35 (1), 63-74 doi: 10.1007/s11031-011-9204-2
    • Westerberg, VM Page 15 of 81Tartaro, J., Luecken, L.J., & Gunn, H.E. (2005). Exploring heart and soul: Effects of religiosity/ spirituality and gender on blood pressure and cortisol stress responses. Journal of Health Psychology, 10 (6), 753-766. doi: 10.1177/1359105305057311Urizar, G.G., & Muñoz, R.F. (in press). Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants. Psychoneuroendocrinology. doi:10.1016/j.psyneuen.2011.04.002U.S. Department of Health and Human Services (2011). Agency for Healthcare Research and Quality (Information Series No. 24). Washington DC: Author. Retrieved September 1, 2011 from http://www.ahrq.gov/White-Traut, R.C., Schwertz, D., McFarlin, B., & Kogan, J. (2009). Salivary cortisol and behavioral state responses of healthy newborn infants to tactile-only and multisensory interventions. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38 (1), 22–34. doi: 10.1111/j.1552- 6909.2008.00307.xWrosch, C., Schulz, R., Miller, G.E., Lupien, S., & Dunne, E. (2007). Physical health problems, depressive mood, and cortisol secretion in old age: Buffer effects of health engagement control strategies. Health Psychology, 26 (3), 341-349. doi: 10.1037/0278-6133.26.3.341
    • Westerberg, VM Page 16 of 813.- APPENDICES (add actual journal articles with continuing page numbers)