The income-happiness nexus: uncovering the importance of social comparison processes in subjective wellbeing.

Introduction: Previous research has established a positive correlation between income and subjective wellbeing (SWB). This correlation is attributed to income's ability to provide material circumstances and influence one's perceived socioeconomic rank in society, known as subjective socioeconomic status (SES). Objective: This study sought to examine whether social comparison processes could mediate the relationship between income and SWB. Specifically, we aimed to explore the impact of comparing one's current socioeconomic situation to individuals from a similar socioeconomic background (referred to as Comsim) on SWB, based on the similarity hypothesis of social comparison theory. Methods: Data stem from two separate two-wave surveys. Study 1 comprised 588 participants, with 294 men and 294 women; age range 25-60 years; mean age 41.5 years). Study 2 comprised 614 participants, with 312 men and 302 women; age range 25-60 years; mean age 43.5 years. In both studies, data on predictors and SWB were collected 3 months apart. Results: In both study 1 and study 2, bivariate analysis demonstrated a positive correlation between income and SWB. However, multivariate regression models revealed that income did not have a direct effect on SWB. Instead, in both studies, subjective SES and Comsim emerged as significant predictors of SWB, with Comsim being the most influential. Furthermore, our formal mediation analysis indicated that subjective SES and Comsim fully mediated the relationship between income and SWB, when combined. Additionally, in study 2, we found that cognitive factors such as personal control, as well as affective factors like self-esteem, played a mediating role between the social comparison processes and SWB. Conclusion: This study contributes to existing research by emphasizing the importance of two distinct social comparison mechanisms in mediating the relationship between income and SWB. Implications: Therapeutic interventions to improve SWB should also consider social comparison processes. From a political standpoint, policies addressing income inequality can mitigate the negative effects of social comparisons on wellbeing. Providing support to those in lower socioeconomic positions can also enhance SWB.

Exploring the relationship between multiple dimensions of subjective socioeconomic status and self-reported physical and mental health: the mediating role of affect.

Introduction: This study aimed to investigate the predictive effects of two types of subjective socioeconomic status on self-reported physical and mental health. Specifically, we examined the MacArthur Scale (MacArthur) which measures perceived socioeconomic rank in the society and a novel scale called ComSim, which assessed how participants compared themselves socioeconomically to others coming from a similar socioeconomic background. We also considered the influence of income, education, and personal relative deprivation (PRD) in these analyses. Additionally, we explored whether these effects were mediated through negative and positive affect. Methods: The data were collected through a cross-sectional, two-wave survey of 294 women and 294 men, with a mean age 41.6 years. Participants were recruited via an online platform. Results: The results from multivariate regression models revealed that socioeconomic status measured with both the MacArthur Scale and ComSim significantly predicted both self-reported health measures, whereas income and education did not predict any of these measures in the full multivariate models. PRD only predicted self-reported mental health. Mediation analyses showed that negative and positive affect mediated the relationships between socioeconomic status measured by ComSim and self-reported health measures. Discussion: These findings are discussed in the context of the similarity hypothesis of social comparison theory. The results underscore the importance of considering multiple dimensions when examining socioeconomic health disparities.

Running to get "lost"? Two types of escapism in recreational running and their relations to exercise dependence and subjective well-being.

Escapism is a fundamental motivation in many forms of activity engagements. At its core, escapism is "a habitual diversion of the mind … as an escape from reality or routine". Accordingly, escapism may entail many adaptive and maladaptive psychological antecedents, covariates, and outcomes. However, few studies have been conducted on escapism as a motivational mindset in running. Here, in a sample of recreational runners (N = 227), we applied a two-dimensional model of escapism, comprising self-expansion (adaptive escapism) and self-suppression (maladaptive escapism), and examined how they were related to exercise dependence and subjective well-being. First, confirmatory factor analyses showed that the escapism dimensions were highly diversifiable in the sample. Then, correlational analyses showed that self-expansion was positively correlated to subjective well-being, whereas self-suppression was negatively related to well-being. Self-suppression was more strongly related to exercise dependence compared to self-expansion. Finally, path analyses evidenced an explanatory role of self-expansion and self-suppression in the inverse relationship between exercise dependence and well-being. In conclusion, the present findings support escapism as a relevant framework for understanding the relationship between exercise dependence in running and subjective well-being.

Explaining socioeconomic disparities in health behaviours: A review of biopsychological pathways involving stress and inflammation.

The purpose of this article was to explore how individuals' position in a socioeconomic hierarchy is related to health behaviours that are related to socioeconomic disparities in health. We identified research which shows that: (a) low socioeconomic status (SES) is associated with living in harsh environments, (b) harsh environments are related to increased levels of stress and inflammation, (c) stress and inflammation impact neural systems involved in self-control by sensitising the impulsive system and desensitising the reflective system, (d) the effects are inflated valuations of small immediate rewards and deflated valuations of larger delayed rewards, (e) these effects are observed as increased delay discounting, and (f) delay discounting is positively associated with practicing more unhealthy behaviours. The results are discussed within an adaptive evolutionary framework which lays out how the stress response system, and its interaction with the immune system and brain systems for decision-making and behaviours, provides the biopsychological mechanisms and regulatory shifts that make widespread conditional adaptability possible. Consequences for policy work, interventions, and future research are discussed.

Subjective Socioeconomic Status, Cognitive Abilities, and Personal Control: Associations With Health Behaviours.

OBJECTIVE: To examine subjective and objective socioeconomic status (SSES and OSES, respectively) as predictors, cognitive abilities as confounders, and personal control perceptions as mediators of health behaviours. DESIGN: A cross-sectional study including 197 participants aged 30-50 years, recruited from the crowd-working platform, Prolific. MAIN OUTCOME MEASURE: The Good Health Practices Scale, a 16-item inventory of health behaviours. RESULTS: SSES was the most important predictor of health behaviours (beta = 0.19, p < 0.01). Among the OSES indicators, education (beta = 0.16, p < 0.05), but not income, predicted health behaviours. Intelligence (r = -0.16, p < 0.05) and memory (r = -0.22, p < 0.01) were negatively correlated with health-promoting behaviours, and the effect of memory was upheld in the multivariate model (beta = -0.17, p < 0.05). Personal control perceptions (mastery and constraints) did not act as mediators. CONCLUSION: SSES predicted health behaviours beyond OSES. The effect of socioeconomic indicators was not confounded by cognitive abilities. Surprisingly, cognitive abilities were negatively associated with health-promoting behaviours. Future research should emphasise SSES as a predictor of health behaviours. Delineating the psychological mechanisms linking SSES with health behaviours would be a valuable contribution toward improved understanding of socioeconomic disparities in health behaviours.

Are unpopular children more likely to get sick? Longitudinal links between popularity and infectious diseases in early childhood.

Social stress and inflammatory processes are strong regulators of one another. Considerable evidence shows that social threats trigger inflammatory responses that increase infection susceptibility in both humans and animals, while infectious disease triggers inflammation that in turn regulates social behaviours. However, no previous study has examined whether young children's popularity and their rate of infectious disease are associated. We investigated the longitudinal bidirectional links between children's popularity status as perceived by peers, and parent reports of a variety of infectious diseases that are common in early childhood (i.e. common cold as well as eye, ear, throat, lung and gastric infections). We used data from the 'Matter of the First Friendship Study' (MOFF), a longitudinal prospective multi-informant study, following 579 Norwegian pre-schoolers (292 girls, median age at baseline = six years) with annual assessments over a period of three years. Social network analysis was used to estimate each child's level of popularity. Cross-lagged autoregressive analyses revealed negative dose-response relations between children's popularity scores and subsequent infection (b = -0.18, CI = -0.29, -0.06, and b = -0.13, CI = -0.23, -0.03). In conclusion, the results suggest that children who are unpopular in early childhood are at increased risk of contracting infection the following year.

A web-based intervention trial for depressive symptoms and subjective well-being in patients with chronic HIV infection.

The current study examined the efficacy of a web-based intervention (WBI; Avanti) on symptoms of depression and well-being for patients diagnosed with HIV. A two-armed randomized trial recruited patients on antiretroviral therapy (ART) at an outpatient clinic. Thirty-six patients were allocated to Avanti and 31 patients to a control group. Primary outcomes were symptoms of depression and subjective well-being (SWB), and secondary outcomes included life satisfaction and affect balance. Paired tests showed that only patients following Avanti had significant improvements in SWB by 3 months as well as affect balance. No significant differences between groups were detected in any of the outcome parameters at baseline after 3 months, as expected from group size and variability in the parameters. However, time since HIV diagnosis and ART initiation moderated the effects of Avanti. In conclusion, our data show that patients with HIV infection may benefit from a WBI in adjunct to medical treatment.

Fear appeals in advanced tobacco control environments: the impact of a national mass media campaign in Norway.

Norway has one of the most comprehensive infrastructures for tobacco control in the world and has launched several media campaigns recent years. Can yet another anti-smoking campaign, using fear appeal messages, have an immediate impact on smoking behavior, motivation to quit and health beliefs? A sample of smokers (N = 2543) completed a survey before and after a 7-week national media campaign. Individual exposure to campaign (unaided recall) was used as predictor of change. We observed no statistically significant effect on smoking status but tendencies were in the expected direction for daily smokers (P = 0.09). There were no effects on number of cigarettes per day, likelihood to quit or reduce smoking. Small but statistically significant effects were found on motivation to quit (P < 0.01, ηp(2) = 0.004) and perceived seriousness of health hazards (P < 0.05, ηp(2) = 0.002). In addition, there was an increase in interpersonal discussions about health and smoking for those exposed to the campaign (P < 0.01, ηp(2) = 0.008). We conclude that there are very small effects of a relatively short and intense mass media campaign on a population of smokers already exposed to one of the most comprehensive tobacco control programs in the world.

Multilevel growth curve analyses of treatment effects of a Web-based intervention for stress reduction: randomized controlled trial.

BACKGROUND: Stress is commonly experienced by many people and it is a contributing factor to many mental and physical health conditions, However, few efforts have been made to develop and test the effects of interventions for stress. OBJECTIVE: The aim of this study was to examine the effects of a Web-based stress-reduction intervention on stress, investigate mindfulness and procrastination as potential mediators of any treatment effects, and test whether the intervention is equally effective for females as males, all ages, and all levels of education. METHODS: We employed a randomized controlled trial in this study. Participants were recruited online via Facebook and randomly assigned to either the stress intervention or a control condition. The Web-based stress intervention was fully automated and consisted of 13 sessions over 1 month. The controls were informed that they would get access to the intervention after the final data collection. Data were collected at baseline and at 1, 2, and 6 months after intervention onset by means of online questionnaires. Outcomes were stress, mindfulness, and procrastination, which were all measured at every measurement occasion. RESULTS: A total of 259 participants were included and were allocated to either the stress intervention (n=126) or the control condition (n=133). Participants in the intervention and control group were comparable at baseline; however, results revealed that participants in the stress intervention followed a statistically different (ie, cubic) developmental trajectory in stress levels over time compared to the controls. A growth curve analysis showed that participants in the stress intervention (unstandardized beta coefficient [B]=-3.45, P=.008) recovered more quickly compared to the control group (B=-0.81, P=.34) from baseline to 1 month. Although participants in the stress intervention did show increases in stress levels during the study period (B=2.23, P=.008), long-term stress levels did decrease again toward study end at 6 months (B=-0.28, P=.009). Stress levels in the control group, however, remained largely unchanged after 1 month (B=0.29, P=.61) and toward 6 months (B=-0.03, P=.67). Mediation analyses showed nonlinear (ie, cubic) specific indirect effects of mindfulness and a linear specific indirect effect of procrastination on stress. In simple terms, the intervention increased mindfulness and decreased procrastination, which was related to lower stress levels. Finally, the effect of the stress intervention was independent of participants' gender, age, or education. CONCLUSIONS: The results from this randomized controlled trial suggest that a Web-based intervention can reduce levels of stress in a normal population and that both mindfulness and procrastination may be important components included in future eHealth interventions for stress. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 25619675; http://controlled-trials.com/ISRCTN25619675 (Archived by Webcite at http://www.webcitation.org/6FxB1gOKY).

A longitudinal study of postpartum depressive symptoms: multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support.

Postpartum depression is a serious health issue affecting as many as 10-15 % of postpartum women. This longitudinal study aimed to explore how psychological variables such as cognitive emotion regulation strategies, breastfeeding self-efficacy (BSE), and dimensions of social support predicted postpartum depressive symptoms (Edinburgh Postnatal Depression Scale). The data were collected with web-based survey questionnaires between May 2008 and December 2009, in a sample of 737 new mothers. The same questionnaire was surveyed at three points in time: 6 weeks, 3 months, and 6 months postpartum. Data were analyzed using multilevel modeling (level 1, time points; level 2, person). Results showed that BSE, certain cognitive emotion regulation strategies, perceived available support, and need for support predicted the rate of postpartum depressive symptoms. Only breastfeeding self-efficacy predicted change in postpartum depressive symptoms. This study illustrates the importance of psychological variables with regard to postpartum depressive symptoms. Implications for preventative efforts are discussed.

A qualitative study of depressive symptoms and well-being among first-time mothers.

BACKGROUND AND AIM: Ten to 15% of women experience postpartum depression. First-time mothers are particularly at risk. The present qualitative study aimed to gain insight in terms of why some women find the transition of becoming a mother to be so emotionally taxing that they feel some level of depressed mood, while others feel mostly content after having a baby. METHOD: Semi-structured interviews were conducted with 12 self-selected first-time mothers. Participants described their pregnancy and birth experience, expectations and experiences with regard to the postpartum period, social support and what they considered important with regard to well-being and depression in the postpartum period. Data were analysed by means of thematic analyses. Ethical approval was granted by the Regional Ethics Committee. RESULTS: Two approaches to motherhood emerged, which we refer to as 'relaxed' and 'controlled'. These approaches influenced how the mothers had envisioned the postpartum period, their need for mastery and how they experienced it emotionally. Social support and managing breastfeeding stood out as important with regard to well-being and depressive symptoms. CONCLUSION: Frequent consultations with midwifes and public health nurses during the pregnancy and the postpartum period gives unique opportunities for preventive work. The consultations should to a greater extent focus on the woman's expectations and needs, and the partner should be present for an open discussion on how they best support each other in this vulnerable period.

A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (happy ending): randomized controlled trial.

BACKGROUND: Happy Ending (HE) is an intense 1-year smoking cessation program delivered via the Internet and cell phone. HE consists of more than 400 contacts by email, Web pages, interactive voice response, and short message service technology. HE includes a craving helpline and a relapse prevention system, providing just-in-time therapy. All the components of the program are fully automated. OBJECTIVE: The objectives were to describe the rationale for the design of HE, to assess the 12-month efficacy of HE in a sample of smokers willing to attempt to quit without the use of nicotine replacement therapy, and to explore the potential effect of HE on coping planning and self-efficacy (prior to quitting) and whether coping planning and self-efficacy mediate treatment effect. METHODS: A two-arm randomized controlled trial was used. Subjects were recruited via Internet advertisements and randomly assigned to condition. Inclusion criteria were willingness to quit on a prescribed day without using nicotine replacement and being aged 18 years or older. The intervention group received HE, and the control group received a 44-page self-help booklet. Abstinence was defined as "not even a puff of smoke, for the last seven days" and was assessed by means of Internet surveys or telephone interviews 1, 3, 6, and 12 months postcessation. The main outcome was repeated point abstinence (ie, abstinence at all four time points). Coping planning and self-efficacy were measured at baseline and at the end of the preparation phase (ie, after 2 weeks of treatment, but prior to cessation day). RESULTS: A total of 290 participants received either the HE intervention (n=144) or the control booklet (n=146). Using intent-to-treat analysis, participants in the intervention group reported clinically and statistically significantly higher repeated point abstinence rates than control participants (20% versus 7%, odds ratio [OR] = 3.43, 95% CI = 1.60-7.34, P = .002). Although no differences were observed at baseline, by the end of the preparation phase, significantly higher levels of coping planning (t(261) = 3.07, P = .002) and precessation self-efficacy (t(261) = 2.63, P = .01) were observed in the intervention group compared with the control group. However, neither coping planning nor self-efficacy mediated long-term treatment effect. For point abstinence 1 month after quitting, however, coping planning and self-efficacy showed a partial mediation of the treatment effect. CONCLUSIONS: This 12-month trial documents a long-term treatment effect of a fully automated smoking cessation intervention without the use of nicotine replacement therapy. The study adds to the promise of using digital media in supporting behavior change.

Happy ending: a randomized controlled trial of a digital multi-media smoking cessation intervention.

AIMS: To assess the long-term efficacy of a fully automated digital multi-media smoking cessation intervention. DESIGN: Two-arm randomized control trial (RCT). Setting World Wide Web (WWW) study based in Norway. PARTICIPANTS: Subjects (n = 396) were recruited via internet advertisements and assigned randomly to conditions. Inclusion criteria were willingness to quit smoking and being aged 18 years or older. INTERVENTION: The treatment group received the internet- and cell-phone-based Happy Ending intervention. The intervention programme lasted 54 weeks and consisted of more than 400 contacts by e-mail, web-pages, interactive voice response (IVR) and short message service (SMS) technology. The control group received a self-help booklet. Additionally, both groups were offered free nicotine replacement therapy (NRT). MEASUREMENTS: Abstinence was defined as 'not even a puff of smoke, for the last 7 days', and assessed by means of internet surveys or telephone interviews. The main outcome was repeated point abstinence at 1, 3, 6 and 12 months following cessation. FINDINGS: Participants in the treatment group reported clinically and statistically significantly higher repeated point abstinence rates than control participants [22.3% versus 13.1%; odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.12-3.26, P = 0.02; intent-to-treat). Improved adherence to NRT and a higher level of post-cessation self-efficacy were observed in the treatment group compared with the control group. CONCLUSIONS: As the first RCT documenting the long-term treatment effects of such an intervention, this study adds to the promise of digital media in supporting behaviour change.

Does socio-economic status and health consciousness influence how women respond to health related messages in media?

During the past few decades, people have been increasingly exposed to health-related messages in the mass media, conveying recommendations for healthy lifestyles. The present study investigates whether these messages represent a stressor, and whether coping responses increase levels of motivation or levels of negative affect. A sample of 403 women aged 45 years were surveyed twice, at an interval of 4 weeks. A substantial proportion of the participants perceived the health messages to be stressful (increased levels of threat). Overall, the participants reported a greater use of adaptive than non-adaptive coping when exposed to the health messages. Socio-economic status (defined in educational terms) was negatively correlated with non-adaptive coping, while health consciousness was positively correlated with adaptive coping. Adaptive coping was positively related, and non-adaptive coping was negatively related, to intentions and behaviours. Non-adaptive coping was associated with stronger negative emotions. The results indicate that less-educated women tend to respond more non-adaptively to health messages than more-educated women; for the former group, this has negative consequences in terms of increased levels of negative emotions and decreased levels of motivation to engage in healthy behaviours.

Perceived difficulty in the theory of planned behaviour: perceived behavioural control or affective attitude?

A study was conducted to explore (a) the dimensional structure of perceived behavioural control (PBC), (b) the conceptual basis of perceived difficulty items, and (c) how PBC components and instrumental and affective attitudes, respectively, relate to intention and behaviour. The material stemmed from a two-wave study of Norwegian graduate students (N = 227 for the prediction of intention and N = 110 for the prediction of behaviour). Data were analysed using confirmatory factor analysis (CFA) and multiple regression by the application of structural equation modelling (SEM). CFA suggested that PBC could be conceived of as consisting of three separate but interrelated factors (perceived control, perceived confidence and perceived difficulty), or as two separate but interrelated factors representing self-efficacy (measured by perceived difficulty and perceived confidence or by just perceived confidence) and perceived control. However, the perceived difficulty items also overlapped substantially with affective attitude. Perceived confidence was a strong predictor of exercise intention but not of recycling intention. Perceived control, however, was a strong predictor of recycling intention but not exercise intention. Affective attitudes but not instrumental attitudes were identified as substantial predictors of intentions. The findings suggest that at least under some circumstances it may be inadequate to measure PBC by means of perceived difficulty. One possible consequence may be that the role of PBC as a predictor of intention is somewhat overestimated, whereas the role of (affective) attitude may be similarly underestimated.

Control constructs: Do they mediate the relation between educational attainment and health behaviour?

Health promoting behaviours seem to be more prevalent among people with higher socio-economic status (SES). The main purpose of this article was to study (a) the relationship between education (as a dimension of SES) and intention and health behaviour (fruit/vegetable consumption), (b) the relationship between education and control conceptualizations (health locus of control (HLC), response-efficacy and self-efficacy) and (c) to what extent the relationship between education and intention/health behaviour (fruit/vegetable consumption) was mediated through different control beliefs. The results showed that women with higher education had higher intentions to consume fruit/vegetables and consumed fruit/vegetables more frequently. Higher education was associated with higher self-efficacy and response-efficacy beliefs and less belief in HLC-chance. These control beliefs partly mediated the education-intention/behaviour relationship.

Expanding the theory of planned behaviour: the role of social norms and group identification.

The purposes of the study were twofold. First, to explore the predictive power of the descriptive and group norms, when the effect of subjective norm had already been accounted for. Second, to investigate to what extent perceived group norm of a behaviourally relevant reference group would predict the intention to use contraception among those who identified strongly with the relevant reference group. The empirical data were generated from a sample of 354 sexually active female adolescents living in Addis Ababa, Ethiopia. The results revealed that subjective (injunctive) norm was the most important predictor of contraceptive intentions (ß = .33, p<.001). In addition, descriptive norms (ß = .20, p <.001) and (unexpectedly) group norm (ß = .11, p <.035) exerted significant main effects upon intention. The study indicated that contraceptive intentions in Ethiopian adolescent girls were influenced more by 'social' (injunctive, descriptive) than 'personal' considerations (attitudes: ß = .20, p <.001, and; PBC: ß = .17, p<.001). However, none of the interaction terms between group identification and social influence variables were significant. Furthermore, collective-self did not emerge to have either a direct effect upon intention, or a moderation effect upon the social norms-intention relationships (as expected).