The effects of safety behaviors on health anxiety: an experimental investigation

The present study examined the extent to which safety behaviors exacerbate symptoms of hypochondriasis (severe health anxiety). Participants were randomized into a safety behavior (n = 30) or control condition (n = 30). After a baseline period, participants in the safety behavior condition spent one week actively engaging in a clinically representative array of health-related safety behaviors on a daily basis, followed by a second week-long baseline period. Participants in the control condition monitored their normal use of safety behaviors. Compared to control participants, those in the safety behavior condition reported significantly greater increases in health anxiety, hypochondriacal beliefs, contamination fear, and avoidant responses to health-related behavioral tasks after the safety behavior manipulation. In contrast, general anxiety symptoms did not significantly differ between the two groups as a function of the manipulation. Mediational analyses were consistent with the hypothesis that changes in the frequency of health-related thoughts mediated the effects of the experimental manipulation on health anxiety. These findings suggest that safety behaviors are associated with increases in health anxiety, perhaps by fostering catastrophic thoughts about health. The implications of these findings for the conceptualization of hypochondriasis as an anxiety disorder are discussed.     

We used to say “Zei gezunt!” (Be well!): Do American Jews still exhibit distinctive health behaviors?

ABSTRACT

A survey that includes a representative sample (n = 3,219) of older persons (age 60+) living in the Philadelphia area was used to determine if health status and health behaviors of older Jews differ from that of non-Jews. The survey includes questions about health status and health behaviors as well as sociodemographic characteristics. Responses of self-identified Jews, Catholics, and Protestants were compared. With only two exceptions there were no differences between Jews and non-Jews on questions about health status. In regard to health behaviors, Jews were more likely to follow standard recommendations such as seeing their physician on a regular basis or yearly screenings for certain cancers. We completed stepwise regressions with measures of socioeconomic status entered first and then Jewish status, as socioeconomic status is closely associated with health outcomes. Being Jewish continued to explain differences in health behaviors even when controlling for socioeconomic status. We also looked at the relation between attending religious services and health behaviors. Self-rated health was correlated with attendance for Protestants and for Catholics; it was not correlated with self-rated health for the Jews. All findings suggest the need for further study of the reason for the relation of health behavior to being Jewish.     

Identifying health-seeking behaviors: a study of adolescents

While it is known that health-seeking behaviors are influenced by information-seeking behaviors, reported research on adolescents' information-seeking behaviors is minimal. Available definitive information primarily addresses ways in which peers, parents, and health professionals are used as sources of information concerning sexuality. Research is now needed on how adolescents use the media and other sources of health information to effect changes in their lives. The present study sought to determine how adolescents' health-seeking behaviors, which include self-management and information-seeking behaviors, differ according to age, race, socioeconomic status, gender, and religion. The study was based on two assumptions: Self-management and information-seeking behaviors are fundamental to adolescents' health-seeking behaviors, and subjects answer self-management and information-seeking questions in terms of past behaviors and their behavioral intent. Important findings that emerged from this investigation include confirmation of gender as a differentiating variable for the performance of information-seeking behavior and positive health behaviors among black adolescents. Further, subjects reported an overall positive composite of health-seeking behaviors.     

Positive and Negative Religious Beliefs Explaining the Religion–Health Connection Among African Americans

Theory and literature suggests that the reason religiously involved people tend to have good health outcomes is because they have healthy lifestyles and behaviors in accord with religious beliefs. Other literature suggests that religious involvement may play a negative role in health outcomes due to beliefs about illness originating as punishment for sins. These ideas were tested as part of a theoretical model of the religion–health connection in a national sample of African Americans. Outcomes included a variety of health-related behaviors. Study participants (N = 2,370) randomly selected from a U.S. national call list completed a telephone survey assessing religious involvement, health behaviors, and demographic characteristics. Structural equation modeling was used to analyze study data. Findings indicate that perceived religious influence on health behavior mediated the relationship between religious beliefs and behaviors and higher fruit consumption and lower alcohol use and smoking. Belief that illness is the result of punishment for sin mediated the relationship between (a) religious beliefs and higher vegetable consumption and lower binge drinking and (b) religious behaviors and lower vegetable consumption and higher binge drinking. These findings could be applied to health education activities conducted in African American faith-based organizations, such as health ministries, in the effort to eliminate health disparities.     

General vs health‐specific consideration of immediate and future consequences to explain eating and exercise behavior in a Norwegian student population: A randomized survey experiment

Over several decades, the consideration of future consequences (CFC) construct has been used to explain and predict health behaviors. However, the reported associations between CFC and health behaviors are relatively weak, leading to the low explanatory power of the models. Recent research suggests that CFC can be a domain‐specific construct. In this study, we explored the psychometric properties of the Norwegian CFC‐general and CFC‐health questionnaires in terms of factor structure and discriminant and convergent validity and tested the association between the general and domain‐specific CFC and exercise and eating behaviors. In a randomized survey experiment, 1,001 university students were assigned to either a CFC‐general or a CFC‐health questionnaire. In the tested models, two dimensions of CFC, consideration of immediate consequences (CFC‐I) and consideration of future consequences (CFC‐F), were independent variables. The exercise and eating behaviors, measured both as self‐evaluated behaviors and self‐reported frequency measures, were dependent variables. The results showed that in both CFC‐general and CFC‐health, CFC‐I and CFC‐F are distinct dimensions that differentially explain variance in health behaviors. A domain‐specific CFC‐health explained a significantly higher amount of variance in self‐reported eating and exercising behaviors than a general CFC. Self‐evaluated health behaviors were better explained by CFC than self‐reported behavioral frequencies. Practical implications of the findings and avenues for future research are discussed.     

Eating Disorders in an Israeli Women’s Prison: Correlates of the Risk

Extensive rates of child abuse and neglect (CAN), substance abuse disorders (SUDs), and mental health problems have been reported among incarcerated women. The link between CAN, SUDs, and eating disorders is well-documented, but little is known about the eating-disorder behaviors of incarcerated women. The purpose of this study was (a) to explore eating-disorder behaviors among incarcerated women in Israel; (b) to examine whether certain types of CAN are associated with eating disorders; and (c) to study the link between CAN, SUDs, mental health problems, and eating disorders. This cross-sectional study investigated eating-disorder behaviors in a sample of 62 incarcerated women in Israel. The findings indicated a high prevalence of eating disorders among incarcerated women; almost 70% exhibited the drive for thinness, which is considered a central feature of eating disorders. In addition, the findings revealed a high prevalence of CAN (84.2%), especially emotional abuse (57.9%) and emotional neglect (73.7%). I also found a high rate of co-occurrence of CAN, SUDs, mental health problems, and eating disorders. Bulimia nervosa, ineffectiveness, and low impulse regulation were found to be associated with SUDs and mental health problems (p?=?0.006, p?=?0.032, and p?<?0.001, respectively). The findings highlight the intersection of trauma with self-destructive behaviors, including co-occurrences of SUDs, eating disorders, and severe mental health problems as a result of negative childhood experiences, suggesting a need for simultaneous treatment interventions.     

Relationships between health behaviors,posttraumatic stress disorder,and comorbid general anxiety and depression

Poor health outcomes associated with posttraumatic stress disorder (PTSD) may reflect engagement in unhealthy behaviors that increase morbidity risk and disengagement in healthy behaviors that decrease morbidity risk. Although research supports this pattern, findings are not definitive, particularly for healthy behaviors. Many studies have not controlled for effects of concurrent generalized anxiety and depression, which might explain conflicting findings. To address this limitation, we used an online cross-sectional research design and multivariate multilevel modelling to evaluate associations between a multitude of health behaviors (i.e. sedentary behavior, sleep quality, physical activity, eating habits, alcohol use and substance use) and PTSD, while adjusting for comorbid generalized anxiety and depression, in a sample of trauma-exposed individuals (N = 246). Our results indicate that PTSD and comorbid generalized anxiety and depression symptoms were differentially associated with specific health constructs. Specifically, sedentary behavior and poor sleep quality were associated with PTSD, whereas low physical activity, poor sleep quality, and unhealthy eating habits were associated with depression. Both increased alcohol and substance use were associated with generalized anxiety. Results from our study highlight the need to conceptualize associations between health behaviors and specific psychological symptoms in a comprehensive manner as part of clinical presentations of PTSD.     

The effect of acculturation and discrimination on mental health symptoms and risk behaviors among adolescent migrants in Israel

This study examines the role of acculturation, perceived discrimination, and self-esteem in predicting the mental health symptoms and risk behaviors among 1.5 and second generation non-Jewish adolescents born to migrant families compared with native-born Jewish Israeli adolescents in Israel. Participants included n = 65 1.5 migrant adolescents, n = 60 second generation migrant adolescents, and n = 146 age, gender, and socioeconomic matched sample of native-born Jewish Israelis. Participants completed measures of acculturation pattern, perceived discrimination, and self-esteem as well as measures of mental health symptoms and risk behaviors. Results show that migrant adolescents across generations reported worse mental health symptoms compared with native-born Jewish Israelis. However, only the 1.5 generation migrants reported higher engagement in risk behaviors compared with second generation migrants and native-born Jewish Israelis. Our findings further showed that acculturation plays an important role in predicting the mental health status of migrant youth, with those characterized with integrated acculturative pattern reporting lower mental health symptoms compared with assimilated acculturation pattern. Importantly, contextual factors, such as higher perception of discrimination in the receiving culture as well as individual factors such as lower self-esteem and female gender were strongly associated with worse mental health symptoms. The findings manifest the complex relationship between contextual factors and individual level variables in the acculturative process of migrants as well as the importance of examining the effect of migration generation on mental health outcomes.     

Dieting and body image in the child's world: conceptualization and behavior

The authors examined children's (N = 431, aged 7 years to 10 years 9 months) understanding of and reasons for dieting, to validate recent research indicating that perceived body-image dissatisfaction and restrictive eating behaviors occur in pre-adolescent populations. Scores on 2 sentence-completion tasks confirmed that the children do have a clear understanding of what dieting means in terms of intent and behavior (defined, in this study, as intentional restrictive eating behaviors). The results indicated that children as young as 7 years of age report dissatisfaction with their current body size and deliberately engage in restrictive eating behaviors. These findings provide validation of previous research and emphasize children's capacity to engage in deleterious health behaviors. Given that extreme dieting behaviors are harmful to a child's physical and psychological well-being, the authors concluded that research exploring (a) the genesis of these attitudes and behaviors and (b) their continuity or discontinuity across childhood is required.     

An Examination of the Individual‐Difference Approach to the Role of Norms in the Theory of Reasoned Action1

The relationship between subjective norm and behavioral intentions is the weakest link of the theory of reasoned action. Numerous approaches have addressed this issue, including the assertion that the weak contribution is a result of a small number of individuals who are under normative control. The present research examines this individual‐difference approach in the domain of health behaviors. Respondents were 287 students who rated their intentions, attitudes, and subjective norms in relation to 32 health behaviors and 5 substance‐use behaviors. Regression analyses, between subjects and within subjects, demonstrated that both behaviors and people can be under attitudinal or normative control. Support for an individual‐difference approach was less conclusive when findings were examined separately for specific health behaviors.     

The effects of message framing on behavioral prevalence assumptions

Based on attribution theory and the logic of conversational norms, we predicted that image‐based health communications can alter prevalence estimates for health behaviors. In two studies, participants were exposed either to a positively‐framed or negatively‐framed communication advocating for specific health behaviors. As predicted, participants who read a health communication rated healthy behaviors as less common when positive attributes were associated with healthy choices than when negative attributes were associated with unhealthy choices. The second study revealed that this pattern was most pronounced among participants who reported initial uncertainty about behavioral norms. These findings suggest that positively‐framed influence attempts can promote prevalence assumptions that work against the influence attempt. Copyright © 2002 John Wiley & Sons, Ltd.     

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Abstract

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.

Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.

Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.

Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.

Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.     

Dieting and Body Image in the Child's World: Conceptualization and Behavior

The authors examined children's (N = 431, aged 7 years to 10 years 9 months) understanding of and reasons for dieting, to validate recent research indicating that perceived body-image dissatisfaction and restrictive eating behaviors occur in preadolescent populations. Scores on 2 sentence-completion tasks confirmed that the children do have a clear understanding of what dieting means in terms of intent and behavior (defined, in this study, as intentional restrictive eating behaviors). The results indicated that children as young as 7 years of age report dissatisfaction with their current body size and deliberately engage in restrictive eating behaviors. These findings provide validation of previous research and emphasize children's capacity to engage in deleterious health behaviors. Given that extreme dieting behaviors are harmful to a child's physical and psychological well-being, the authors concluded that research exploring (a) the genesis of these attitudes and behaviors and (b) their continuity or discontinuity across childhood is required.     

The Krantz Health Opinion Survey: correlations with preventive health behaviors and intentions

The Krantz Health Opinion Survey, a measure of treatment preferences, was administered to 124 college women who also completed the Multidimensional Health Locus of Control Scale and rated their own preventive health behaviors and intentions. Analysis confirmed previous findings of relations between the two scales, particularly the moderate negative correlation between the Krantz Behavioral Involvement Scale and Powerful Others Locus of Control. The Krantz scores also were correlated with demographic measures such as education and occupation of the head of the household. With the exception of low correlations with frequency of obtaining Pap tests and with intentions to engage in exercise, the Krantz scores were uncorrelated with preventive health behaviors and intentions. It may be that another variable such as health value moderates these associations.     

False Consensus and False Uniqueness in Estimating the Prevalence of Health-Protective Behaviors

The degree to which people perceive that their health-relevant behaviors are also performed by their peers may influence whether they continue these practices or are susceptible to change. The present paper examined estimates of social consensus for health-relevant behaviors. It was hypothesized that respondents would perceive their own behaviors to be relatively more common than do people not performing them, the so-called False Consensus Effect. However, in terms of the accuracy of consensus estimates, people who behave in undesirable ways will tend to overestimate the actual number of others who behave similarly. In contrast, people who behave in desirable ways will underestimate the actual number of people who behave like themselves (false uniqueness). A group of college-aged males were asked to report about their performance of a series of health-relevant behaviors and to estimate the frequency of each behavior among their peers. The findings strongly supported the first two hypotheses and provided some support for the third. One practical implication of the results is that persons with unhealthy practices may resist public health campaigns and other interventions by overestimating consensus for their own behaviors. Also, individuals who think their undesirable health behaviors are relatively common may believe that they involve few health risks for them. The research suggests the need for further research on social cognitions about health, illness, and health-protective behaviors.     

Mindfulness facets,trait emotional intelligence,emotional distress,and multiple health behaviors: A serial two‐mediator model

In the present study, we tested a serial mindfulness facets‐trait emotional intelligence (TEI)‐emotional distress‐multiple health behaviors mediation model in a sample of N = 427 German‐speaking occupational therapists. The mindfulness facets‐TEI‐emotional distress section of the mediation model revealed partial mediation for the mindfulness facets Act with awareness (Act/Aware) and Accept without judgment (Accept); inconsistent mediation was found for the Describe facet. The serial two‐mediator model included three mediational pathways that may link each of the four mindfulness facets with multiple health behaviors. Eight out of 12 indirect effects reached significance and fully mediated the links between Act/Aware and Describe to multiple health behaviors; partial mediation was found for Accept. The mindfulness facet Observe was most relevant for multiple health behaviors, but its relation was not amenable to mediation. Implications of the findings will be discussed.     

Neuroticism and depressive symptoms among spouse caregivers: do health behaviors mediate this relationship?

This study examined the mediating role of health behaviors in the relationship between neuroticism and depressive symptoms among spouse caregivers. Path analysis was used to test a model of the caregiver stress process among 233 caregivers of people with dementia. Results indicate that neuroticism has a significant direct effect on depressive symptoms and also indirectly influences depressive symptoms through health behaviors and perceived stress. When individual health behaviors were examined in the path model, only physical activity served a significant mediating role. These findings suggest that neuroticism may lead to depressive symptoms among caregivers partly through declines in physical activity.     

Big Five traits,affect balance and health behaviors: A self-regulation resource perspective

Despite the relatively consistent finding that Conscientiousness, Agreeableness and low Neuroticism are associated with the practice of health-promoting behaviors, the reasons for these linkages are not well understood. This prospective study addressed this gap by taking a self-regulation resource perspective on why these traits relate to health-promoting behaviors by examining the role of higher positive relative to negative state affect. Students completed baseline (N = 330), and two week follow-up (N = 195) surveys. Bootstrapping analyses of the indirect effects of each of the three traits on Time 2 health behaviors were significant in the expected directions, with Kappa squares ranging from .11 to .13. In the full longitudinal analyses controlling for Time 1 health behaviors, the indirect effects of Conscientiousness and Agreeableness through affect balance on Time 2 health behaviors were positive and significant, whereas the indirect effects through Neuroticism were negative and significant after accounting for the Time 1 practice of health behaviors. These findings provide a process-oriented understanding of how Big Five traits are linked to health-promoting behaviors and extend previous research supporting a self-regulation resource perspective on personality and health behaviors.