Sex Differences in Social Support and Self-Efficacy Within a Recovery Community

This study examined similarities and differences in social support and self-efficacy for abstinence between women and men recovering from substance addiction. The sample consisted of 87 residents of Oxford House (OH) self-run, community-based recovery homes. Analyses revealed similarities between women and men in terms of the composition and utilization of support networks and abstinence self-efficacy. Also, for both sexes, length of residency in OH was significantly related to decreased social support for alcohol and drug use and increased self-efficacy for abstinence. However, multiple-group SEM analyses demonstrated that social support for alcohol/drug use fully mediated the link between length of residency and abstinence self-efficacy for women, but not for men. Findings suggest that the process of gaining self-efficacy to remain abstinent is distinct for women and men, and that social support plays a different role in women's recovery than it does in men's.     

A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self-Help Settings

A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents' psychiatric severity were examined at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity reported significantly more days using psychiatric medication, decreased outpatient psychiatric treatment, yet no significant differences for number of days abstinent and time living in an Oxford House. These findings suggest that a high level of psychiatric severity is not an impediment to residing in self-run, self-help settings such as Oxford House among persons with psychiatric comorbid substance use disorders.     

Increases in Tolerance Within Naturalistic, Intentional Communities: A Randomized, Longitudinal Examination

The authors examine differential changes in values of tolerance among 150 participants discharged from inpatient treatment centers, and randomly assigned to either a self-help-based, communal living setting (i.e., Oxford House), or usual aftercare. Participants were interviewed every 6 months for a 24-month period. Hierarchical linear modeling (HLM) was used to examine the effect of condition (therapeutic communal living versus usual aftercare) on wave trajectories of tolerance (i.e., universality/diversity scores). Over time, residents of the communal living model demonstrated significantly greater values of tolerance than usual aftercare participants. Communal living participants who resided in the house for over 6 months showed the most substantial increases in tolerance. Results support the notion that communal living residents may develop more tolerant attitudes by striving toward superordinate community goals (objectives held by (a) the whole group and (b) which individual members could not achieve alone).     

Changes in Hypothesized Mechanisms of Change Before and After Initiating Abstinence in Cognitive-Behavioral Therapy for Women With Alcohol Use Disorder

Abstinence self-efficacy, coping skills, and therapeutic alliance are hypothesized mechanisms of behavioral change (MOBCs) in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). However, little is known about when these hypothesized MOBCs change during treatment or in relation to the initiation of abstinence from alcohol, which the current study investigated. Patient-reported abstinence self-efficacy, drinking-related coping skills, and therapeutic alliance were measured at every session throughout a 12-session clinical trial that previously showed equivalent drinking reductions in female-specific individual- and group-based CBT for AUD. Participants (N = 121 women) were classified into subgroups based on whether and when they first initiated 14 days of continuous abstinence from alcohol during treatment. Interrupted time-series analyses evaluated the magnitude and timing of change in MOBC variables in relation to the initiation of abstinence. All three MOBC measures showed gradual improvements throughout treatment (within-subjects d = 0.03 to 0.09 change per week). Participants who initiated abstinence during treatment experienced additional sudden improvements in abstinence self-efficacy (d = 0.47) and coping skills (d = 0.27), but not therapeutic alliance (d = -0.02), the same week they initiated abstinence. Participants who were already abstinent when treatment started maintained higher abstinence self-efficacy and coping skills, but not therapeutic alliance, throughout treatment compared to participants who never initiated abstinence. Initiating abstinence may help facilitate improvements in abstinence self-efficacy and drinking-related coping skills. Clinicians may help patients anticipate when and how much these variables are expected to improve during treatment and encourage initiation of abstinence to potentially help facilitate improvements in abstinence self-efficacy and coping skills.     

AN EXPERIMENTAL COMPARISON OF THREE DIFFERENT SCHEDULES OF REINFORCEMENT OF DRUG ABSTINENCE USING CIGARETTE SMOKING AS AN EXEMPLAR

The efficacy of three different schedules of reinforcement for promoting and sustaining drug abstinence was compared in this study. Cigarette smoking was studied as an exemplar of stimulant drug self-administration. Sixty cigarette smokers were assigned to one of three groups (progressive rate of reinforcement, fixed rate of reinforcement, and yoked control). Participants in all three groups were asked to refrain from smoking for 1 week. Participants in the progressive and fixed groups achieved greater mean levels of abstinence than those in the control group. Participants in the progressive group were significantly less likely to resume smoking when they became abstinent than participants in the other groups.     

Optimism and Hope After Multiple Disasters: Relationships to Health-Related Quality of Life

Natural and technological disasters are devastating events for individuals and communities. The authors examined the role of optimism and hope in predicting health indicators in a sample of disaster survivors who were exposed to Hurricanes Katrina and Rita in 2005. Participants were noncoastal residents, current coastal residents, and current coastal fishers who were also economically impacted by the 2010 BP Deepwater Horizon oil spill. All participants completed measures of optimism, hope, and the SF-36 Health Survey, which provides summary scores for mental and physical health. Logistic regressions indicated that optimism and hope were independently and positively associated with better mental health (OR = 1.21; 95% CI: 1.10, 1.32 and OR = 1.11; 95% CI: 1.05, 1.17 respectively). Neither optimism nor hope were significantly associated with physical health when considered alone. However, optimism interacted with prior lifetime trauma, where optimism only significantly predicted physical health for those with higher previous trauma scores. These results provide new evidence of optimism and hope as protective factors that may positively impact mental health after multiple disasters.     

Cognitive,Behavioral, and Personality Correlates of HIV-Positive Persons' Unsafe Sexual Behavior1

This study examined sexually risky behaviors of HIV-positive men and women within the framework of social cognitive theory. Condom use was found to be associated with high self-efficacy, positive influeces from social models, and specific condom use expectancies. As risky sexual behavior may be the manifestation of a more general pattern of risk taking that emerges from personality dispositions such as impulsiveness or psychoticism, this possibility was explored with discriminant analyses. Self-reported impulsivity, substance abuse, promiscuity, and deception served as markers of the presumed disposition. While these variables did not reliably distinguish between consistent and inconsistent condom users, they did enhance significantly the classification of individuals who, during the past 6 months, had been sexually abstinent, monogamous, or nonmonogamous. Those who reported more sex partners scored higher on impulsivity, disclosed more involvement with illegal drugs, and showed greater willingness to mislead potential partners about their sexual history than monogamous or sexually abstinent persons with HIV.     

Effects of biochemical validation of self-reported cigarette smoking on treatment success and on misreporting abstinence

Many investigators have reported that cigarette smokers who are trying to quit often falsely report being abstinent at the end of treatment. Unfortunately, much of the previous research designed to investigate this problem has been flawed, making the results difficult to interpret. We attempted to avoid these flaws and to investigate the measurement of alveolar carbon monoxide (CO) levels to validate self-reported smoking rates at the end of treatment. Participants in behavioral cessation clinics were randomly assigned to one of three conditions that varied in timing of exposure to information regarding CO measurement: at the beginning of treatment (demonstration of CO measurement, discussion of smoking effects on CO levels, and notification that individual CO levels would be measured at the conclusion of the clinic), at the end of treatment (demonstration, discussion, and notification of CO measurement prior to self-reports of smoking levels), or at the end of treatment (demonstration and discussion of CO measurement subsequent to self-reports of smoking levels). CO levels of all participants were measured at the end of treatment after they reported their current smoking levels. Only 16% of self-reports of abstinence were not verified by CO measurement. Smokers who observed the CO demonstration at the beginning of treatment were significantly more likely than the other two groups to achieve abstinence at the end of treatment and significantly less likely to misreport abstinence. Clinical and research implications of these results are discussed.     

Dream of absent-minded transgression: an empirical study of a cognitive withdrawal symptom.

Among 293 smokers abstinent for between 1 and 4 weeks, 33% reported having at least 1 dream about smoking. In most dreams, subjects caught themselves smoking and felt strong negative emotions, such as panic and guilt. Dreams about smoking were the result of tobacco withdrawal, as 97% of subjects did not have them while smoking, and their occurrence was significantly related to the duration of abstinence. They were rated as more vivid than the usual dreams and were as common as most major tobacco withdrawal symptoms. In subjects abstinent for 1 year, 63% recalled having dreams about smoking. They had on average 5 of them, and about a quarter occurred after the 6th month of abstinence. Having dreams about smoking was prospectively positively related to maintenance of abstinence. An explanation of this finding based on the association of smoking in dreams with aversive emotions is offered.     

Cognitive factors and willingness to participate in an HIV vaccine trial among HIV-positive injection drug users

There are gaps in our knowledge of the role cognitive factors play in determining people's willingness to participate (WTP) in therapeutic HIV vaccine trials. Using a cross-sectional study of HIV-positive injection drug users (IDU), we determined the role of three cognitive factors: HIV treatment optimism, self-efficacy beliefs, and knowledge of vaccine trial concepts in relation to WTP in a hypothetical phase 3 therapeutic HIV vaccine trial. WTP was 54%. Participants tended to be low in HIV treatment optimism (mean?=?3.9/10), high in self-efficacy (mean?=?79.8/100), and low in knowledge (mean?=?4.1/10). Items pertaining to HIV treatment optimism and knowledge of HIV vaccine trial concepts were generally unrelated to WTP. An increase in self-efficacy had a statistically significant positive association with WTP (OR?=?1.61, 95% CI?=?1.04-2.46, p?相似文献   

Perceptions of goal-directed activities of optimists and pessimists: a personal projects analysis

In this research the authors examined the relationship between optimism and personal projects in a community sample. Three hundred twenty-five community volunteers completed the Personal Projects Analysis (PPA; B. R. Little, 1983) and measures of self-reported optimism and sociodemographic information. Participants who reported high levels of optimism rated their idiosyncratic personal goals significantly higher on PPA factors reflecting Positive Identity Fulfillment and Mastery-Control and significantly lower on the factor reflecting Perceived Strain than did participants who reported low levels of optimism. After the impact of age and education on optimism were statistically controlled, the Perceived Strain and Mastery-Control factors made significant contributions to the prediction of self-reported optimism in both initial and cross-validation samples. Findings indicate that highly optimistic individuals can be differentiated from their less optimistic peers on the basis of their perceptions of idiosyncratic goals. From an expectancy valence perspective, such differences have a direct bearing on individuals' behavior and may be associated with outcomes such as learned helplessness and procrastination.     

The Effects of Hurricane Katrina on Females with a Pre-Existing Fear of Storms

The purpose of this study was to determine the effects of Hurricane Katrina on those with preexisting storm fear. Participants were divided into two groups, those with a fear of storms and control participants with no reported fears of any specific stimuli. Differences were examined on measures of exposure to and distress from trauma, fear, coping self-efficacy, and demographic variables. The participants were 62 female undergraduate college students who completed an online survey examining the effects of Hurricane Katrina. Despite no differences in the overall occurrence of trauma between the two groups, storm-fearful participants reported significantly more overall distress from their exposure when compared to the non-fearful participants. Those with storm-fears also reported significantly poorer coping self-efficacy following the storm than those who were not fearful. Overall, individuals with a fear of storms reported experiencing greater psychological impact and poorer coping self-efficacy from the same degree of storm exposure.     

Trauma and sex surveys meet minimal risk standards: implications for institutional review boards

Institutional review boards assume that questionnaires asking about "sensitive" topics (e.g., trauma and sex) pose more risk to respondents than seemingly innocuous measures (e.g., cognitive tests). We tested this assumption by asking 504 undergraduates to answer either surveys on trauma and sex or measures of cognitive ability, such as tests of vocabulary and abstract reasoning. Participants rated their positive and negative emotional reactions and the perceived benefits and mental costs of participating; they also compared their study-related distress with the distress arising from normal life stressors. Participants who completed trauma and sex surveys, relative to participants who completed cognitive measures, rated the study as resulting in higher positive affect and as having greater perceived benefits and fewer mental costs. Although participants who completed trauma and sex surveys reported slightly higher levels of negative emotion than did participants who completed cognitive measures, averages were very low for both groups, and outliers were rare. All participants rated each normal life stressor as more distressing than participating in the study. These results suggest that trauma and sex surveys pose minimal risk.     

Psychological distress and well-being in advanced cancer: The effects of optimism and coping

This study examined the relations among optimism, coping, functional status, and psychological adjustment in 75 adults diagnosed with cancer. Both the positive and the negative aspects of psychological adjustment were assessed. All participants had been diagnosed with advanced stages of cancer (i.e., Stages II, III, and IV). Participants completed three assessments across a 4-month time period. Both optimism and coping were associated with psychological adjustment, even after controlling for functional status and prior adjustment. Additionally, optimism and coping were differentially related to distress and well-being. Optimism was strongly and positively associated with well-being and inversely related to distress. Escape-Avoidance coping was positively associated with distress and Accepting Responsibility coping was negatively associated with well-being. Comparisons between the current and prior studies indicated that individuals who are diagnosed with more advanced stages of cancer or who have survived bone marrow transplantation exhibit higher levels of optimism than do healthy individuals and individuals with early-stage disease.     

Cognitions associated with recovery from alcohol dependence1

The present study examined the cognitive factors uniquely associated with the status of alcohol dependence recovery, assessing Korean patients who were recovered (n = 57), having been alcohol‐abstinent for 4 months or more after treatment, and who were nonrecovered (n = 213), being still in treatment. Compared with the nonrecovered group, the recovered group reported lower levels of denial of drinking problems and rationalization of drinking (two dimensions of specific beliefs that facilitate alcohol use), dysfunctional attitudes, depressed mood, and emotion‐focused coping. The recovered group also showed higher levels of alcohol abstinence self‐efficacy and problem‐focused coping. Both denial and alcohol abstinence self‐efficacy were uniquely associated with alcohol dependence recovery, when we controlled for the other relevant predictors, whereas neither dysfunctional attitudes nor rationalization were so associated. These findings could be useful in refining psychological interventions facilitating the recovery of alcohol‐dependent patients.     

Racial identification, racial discrimination, and substance use vulnerability among African American young adults

Two studies examined racial identity (RI) as a protective factor against substance use cognitions among African American young adults who either envisioned or experienced racial discrimination. In Study 1, participants envisioned a discrimination or nondiscrimination scenario, and then their willingness to use drugs and an indirect measure of substance use were assessed. Discrimination was associated with higher levels of use cognitions among participants with low levels of RI. In Study 2, participants were excluded or included in an online game (Cyberball) by White peers and then engaged in an RI-affirmation or control writing task. Participants attributed this exclusion to racial discrimination. Excluded participants who did not affirm their RI reported the highest levels of substance use cognitions, especially if they had engaged in higher levels of previous substance use. These findings highlight the importance of RI among Black young adults and the impact of discrimination on health behaviors.     

Perceptions of self-efficacy in providing multidimensional school-age stuttering therapy among board certified fluency specialists in the United States

PurposeThe purpose of this study was to document fluency specialists’ self-efficacy beliefs for providing multidimensional treatment to children who stutter and to identify cognitive, affective, and behavioral correlates of self-efficacy.MethodSixty-six Board Certified Specialists in Fluency in the United States completed an online survey measuring self-efficacy in providing multidimensional stuttering therapy, perceived importance of multidimensional aspects of therapy, feelings of comfort in providing therapy, perceived treatment success, and employment and demographic questions. Open-ended questions were also asked for participants to describe why they chose to specialize and what benefits they received from it.ResultsParticipants reported high levels of self-efficacy (averages above 9 on a scale from 0 to 10) in speech-related, cognitive, emotional, and social domains of stuttering therapy, as well as high levels of comfort and clinical success. Higher ratings of overall self-efficacy were significantly correlated with beliefs about the importance of multidimensional treatment, τ = 0.27, treatment comfort, τ = 0.25, and self-reported treatment success, τ = .49. Responses indicated that many participants believed that their self-efficacy grew because of specialty certification.ConclusionAlthough not the same as treatment outcome data, self-efficacy among clinical service providers is an important variable to consider. Board Certified Specialists in Fluency in the United States report very high levels of self-efficacy for school-age stuttering treatment. The process of certification helps to increase self-efficacy and provides a means for advertising competence in stuttering treatment. This information could help in recruiting the next generation of fluency specialists.     

Relations Among Ethnicity, Gender, Beliefs, Attitudes, and Intention to Pursue a Career in Information Technology

Using data from 159 African Americans and 98 Anglo Americans, we examined relations among ethnicity, gender, information technology (IT) self-efficacy, occupational stereotypes, attitudes toward IT, and IT career intentions. Results revealed that IT self-efficacy and occupational stereotypes were related to attitudes toward IT jobs, and these attitudes were positively related to career intentions. In addition, there were ethnic and gender differences in IT self-efficacy and occupational stereotypes. In particular, African American men reported higher levels of IT self-efficacy, whereas Anglo American women reported lower levels of IT self-efficacy than did members of all other groups. Furthermore, Anglo Americans had more negative stereotypes of IT professionals than did African Americans. Implications for research and practice are discussed.     

Abstinence and well-being among members of Alcoholics Anonymous: personal experience and social perceptions

The authors examined the subjective experience of well-being (WB) among abstinent Alcoholics Anonymous (AA) members and social perceptions of an abstinent alcoholic's WB among 3 nonalcoholic French-Canadian samples: male police officers, Catholic nuns, and university women. The short-term abstinent AA members, along with the university women, reported the lowest self-ratings of WB, whereas the Catholic nuns reported the highest. However, among the abstinent AA members, the level of WB was positively related to the length of abstention. The 3 nonalcoholic groups evaluated an abstinent AA member more positively than a nonabstinent alcoholic. These evaluations of an abstinent AA member converged with the AA members' self-evaluations on the measure of WB.     

Sun protective behaviour,optimism bias,and the transtheoretical model of behaviour change

This study investigated the relationship between sun protective behaviours and three psychological variables influencing health behaviour: decisional balance, optimism bias, and the transtheoretical model of behaviour change. Two hundred participants completed the ‘Readiness to Alter Sun Protective Behaviour’ questionnaire, and a short questionnaire investigating optimism bias, decisional balance, attitudes, and experiences of sun protection and skin cancer. Participants were evenly distributed between the precontemplation, contemplation, and action stages. Participants in the action stage were significantly more likely to endorse the perceived advantages associated with sun protective behaviour than participants in the precontemplation and contemplation stages. They also reported sunbathing significantly less—and being more concerned about contracting skin cancer—than participants in the earlier stages. Decisional balance and optimism bias scores varied systematically across the stages of change; however, decisional balance was the only significant psychological predictor of sun protective behaviours. Optimism bias was greatest in the precontemplation stage, whereas the action stage was characterised by more positive attitudes to sun protection. This suggests that knowledge of the real risks of skin cancer might be a precursor to behaviour change, but only a change in attitudes results in a move to the action stage and measurable behaviour change.