Micro Versus Macro Processes: How specific stress exposure impacts sleep, affect, and risk-related behavior on the path to disease in high-risk adults.

BACKGROUND: The stress-to-disease association has been well-accepted for some time. However, the understanding of how stress exposure contributes to psychological disease progression remains unclear. OBJECTIVE: To test the real-time impact of variable stress exposure on risk-related clinical phenomena and affective disease progression in a high-risk sample of active-duty firefighters. METHODS: Participants completed weekly diaries reporting stressful event exposure, affect, sleep, and risk-related and healthy behaviors over six-months and were evaluated for lifetime and current psychiatric disease using clinical interviews before and after the sampling period. RESULTS: Stress exposure impacted clinical phenomena in differing ways. Major personal events and day-to-day hassles predicted health-impairing shifts in sleep and behavior that were associated with increases in symptoms and psychological distress over the 6-month period. In contrast, highly aversive incidents predicted greater adaptive behaviors that were uniquely predictive of symptom decreases over the six-month period. CONCLUSION: These findings shed new light on stress-to-disease processes, demonstrating how variable stress exposure influences critical shifts in behavior and sleep, contributing to psychological adjustment of firefighters over time. These data suggest practical ways to monitor risk in high-risk samples (e.g., monitoring sleep latency) and offer avenues for further explication of disease processes in real time.

Feel to Heal: Negative Emotion Differentiation Promotes Medication Adherence in Multiple Sclerosis.

Multiple Sclerosis (MS) is a debilitating chronic autoimmune disease of the central nervous system that results in lower quality of life. Medication adherence is important for reducing relapse, disease progression, and MS-related symptoms, particularly during the early stages of MS. However, adherence may be impacted by negative emotional states. Therefore, it is important to identify protective factors. Past research suggests that the ability to discriminate between negative emotional states, also known as negative emotion differentiation (NED), may be protective against enactment of maladaptive risk-related behaviors. However, less is known as to how NED may promote adaptive health behaviors such as medication adherence. Utilizing weekly diaries, we investigated whether NED moderates the association between negative affect and medication adherence rates across 58 weeks among patients (n = 27) newly diagnosed with MS (following McDonald criteria). Results revealed that NED significantly moderated the relationship between negative affect and medication adherence. Specifically, greater negative affect was associated with lower adherence only for individuals reporting low NED. However, this link disappeared for those reporting moderate to high NED. Building upon past research, our findings suggest that NED may promote adaptive health behaviors and have important clinical implications for the treatment and management of chronic illness.