Differences in psychosocial factors and fat consumption between stages of change for fat reduction

Abstract

Differences in fat consumption and psychosocial factors between subjects in different trans-theoretical stages of change for fat reduction were studied. Data on fat consumption, self-rated fat intake, attitudes, social support and self-efficacy were collected among a sample of 507 adults. Analysis of variance with Scheffe's multiple-comparison test was used to study differences in these factors between stages of change. Attitudes and social support were most positive among subjects in preparation and action. Self-efficacy expectations were lowest among subjects in contemplation and preparation. Fat consumption was highest among precontemplators hut no substantial differences between other stages were found. It is concluded that subjects in different stages of change differ in psychosocial factors that are regarded as important determinants of behavioral change. Based on these differences it is recommended to develop stage-tailored nutrition education. A majority of subjects in maintenance consumed more fat than is recommended. Therefore, it is suggested that the usually applied staging algorithms might need adjustment for a valid application in nutrition research.     

Self-injury and readiness to recover: Preliminary examination of components of the stages of change model

The purpose of this study was to examine non-suicidal self-injury (NSSI) recovery through the lens of the transtheoretical model of stages of change. To do this, a content analysis of online posts about NSSI from 73 participants (M_age = 19.4; SD_age = 5.49) with a history or NSSI was performed. Specifically, two rubrics were used. The first examined stages of change and the other positive and negative views toward NSSI recovery. Results indicated that a preponderance of posts was in the precontemplation (39.7%) and contemplation (52.1%) stages. Individuals in the contemplation stage mentioned significantly more disadvantages than advantages to change compared to those in the precontemplation stage. Overall, the current study provides preliminary evidence for the utility of stages of change when conceptualizing NSSI recovery. Implications for research and practice are addressed.     

Stages of change in fruit intake: A longitudinal examination of stability,stage transitions and transition profiles

The present study examined stability and transitions in Transtheoretical stages of change for fruit intake in an adult cohort of 735 individuals not exposed to a planned intervention. Six assessments took place within a four-month period with varying time intervals using electronic questionnaires, measuring fruit intake, stage of change and demographic characteristics. Precontemplation and maintenance were the most stable stages of change, while preparation was the least stable. Longer time intervals showed lower stability, but frequent stage transitions also occurred in shorter time intervals. Seven transition profiles were distinguished. Sequences within transition profiles mostly showed stage transitions to adjacent stages, independent of the interval duration. Differences in fruit intake, age, level of education and ethnicity were found between different transition profiles. Stability rates and most transition sequences largely support the Transtheoretical Model. Results indicating potential deviations from the model, e.g. short-term stage instability and stage transition profiles not in accordance with the Transtheoretical Model are discussed.     

Stages of change in anxiety: psychometric properties of the University of Rhode Island Change Assessment (URICA) scale

Readiness for change is increasingly cited as an important variable in the health behaviours literature, yet there remains a dearth of research related to this construct in mental health. This study examined the psychometric properties of the University of Rhode Island Change Assessment (URICA) scale in two samples. In Study 1 (n = 252), undergraduates completed the URICA and were administered measures of hopelessness, the consequences of worry, self-esteem, anxious symptomatology, and social desirability. The reliability and validity of the URICA were generally supported, although the goodness-of-fit with the intended subscales was only moderate. The Precontemplation, Contemplation and Maintenance subscales correlated as expected with ancillary measures, but the Action subscale did not. In Study 2 (n = 81), individuals with panic disorder were administered the URICA at initial assessment and following cognitive behavioural therapy. The URICA demonstrated excellent reliability, significantly predicted treatment retention and dropout, and showed modest utility for predicting treatment outcome. Confirmatory factor analysis, however, revealed an inadequate fit to the intended subscales. The implications of these findings are discussed and directions for future research highlighted.     

A unitary Neo-Piagetian/Neo-Eriksonian model of development: Fundamental assumptions and meta-issues

The article briefly reviews a stage model of change in human development that integrates a Neo-Piagetian model and a Neo-Eriksonian model into one unitary stage model across the lifespan (as presented in Young, 2011). The model suggests a generic model of stages in change. The article explores the fundamental assumptions underlying the model as well as considering meta-issues. The article adds to the book by describing the Neo-Eriksonian stages as reflections of a social “participatory” process. It adds to the change process in development by describing it as possibly reflecting “punctuated disequilibrium.” Finally, it adds a “multiple psychodynamics” model.     

Modelling determinants of walking and cycling adoption: A stage-of-change perspective

Shifting travel away from cars and towards more active modes has proven a formidable policy challenge. This study aims to uncover the determinants of walking and cycling adoption by applying a stage-of-change framework. Drawing on the Transtheoretical Model, this framework models the adoption of active modes as a series of stages from pre-contemplation to maintenance. Ordinal logit models applied to US data (n = 914) illustrate the importance of both observable demographic-personal and perceptual-attitudinal variables for determining stage-of-change membership. Comparing walking and cycling, the model reveals both shared variables (vehicle ownership, self-identity) and differing factors (gender, environmental spatial ability) distinguishing among adoption stages, which has significant implications for transport policy. Results indicate that a model combining both demographic-personal and perceptual-attitudinal factors has the best fit and validity, suggesting that travel behavior interventions would benefit from multivariate segmentation methods that consider an array of individual and group characteristics. This research also gives evidence of different determinants motivating change processes for cycling versus walking. Taken together, results suggest a need for tailored policy interventions to promote behavioural adoption based not merely on the specific mode selection, but also on the usage stage under consideration.     

Common principles of psychotherapeutic change: patterns of use

ABSTRACT

Many authors have proposed the existence of common principles of counselling and psychotherapeutic change. However, little is known about how practitioners use these change principles. A sample of 373 Czech psychotherapists and counsellors participated in an online survey and rated their use of 10 psychotherapy change principles in their practice over the previous year. The frequency of the use of the 10 change principles is reported. Furthermore, three principal components of the change principles were identified: exploration, acceptance, and understanding of clients’ experience; attending to clients’ own resources; and furnishing clients with new skills and advice. The use of these components was mainly associated with the practitioner's theoretical orientation. The implications of the component structure for psychotherapist and counsellor training and practice are discussed.     

Expectations of reducing fat intake: The role of perceived need within the theory of planned behaviour

Abstract

Dietary fat intake has been implicated in the causation of major diseases including coronary heart disease and cancer. Hence, current recommendatioris to improve health emphasise the reduction of fat intake (COMA, 1991). The present study investigated the effect of perceived need to reduce fat intake and past behaviour on peoples' expectations of reducing fat intake, using the framework of the Theory of Planned Behaviour (TPB) (Ajzen, 1985; 1991). The effects of estimated fat intake and body weight on perceived need to reduce were also investigated. One hundred and fifty-two adults completed a four-day weighed dietary record and completed a questionnaire based on the TPB. Perceived need to reduce fat intake, cognitive and affective components of attitude and past behaviour wm found to be significant predictors of expectation of reducing fat intake. Perceived body weight and estimated fat intake were significant predictors of perceived need to reduce fat intake. The implications of these findings for health promotion policy are discussed.     

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.     

Eating styles in the morbidly obese: Restraint eating,but not emotional and external eating,predicts dietary behaviour

Objectives : The research explored (1) the relationships between self-reported eating style (restraint, emotional and external eating) and dietary intake and (2) emotional eater status as a moderator of food intake when emotional, in a morbidly obese population.

Design : A sample of 57 obese participants (BMI: M?=?51.84, SD?=?8.66) completed a five-day food diary together with a reflective diary, which assessed eating style and positive and negative affect daily.

Main outcome measures : A dietician-scored food pyramid analysis of intake.

Results : Restraint eating was the only predictor (negative) of overall food intake and the variable most strongly associated with the consumption of top-shelf foods. Emotional and external eating were unrelated to food intake. Emotional eater status did not moderate food intake in response to positive and negative mood states.

Conclusion : The findings indicated largely analogous relationships between eating style and dietary intake in this obese sample compared with previous results from healthy populations. The lack of predictive validity for emotional eating scales (when emotional) raises questions over people’s ability to adequately assess their eating style and consequently, the overall validity of emotional eater scales.     

Team change climate: A group-level analysis of the relationships among change information and change participation,role stressors,and well-being

We explored whether teams develop shared perceptions regarding the quantity and quality of information and the extent of participation in decision making provided in an environment of continuous change. In addition, we examined whether change climate strength moderated relationships between change climate level and team outcomes. We examined relationships among aggregated change information and change participation and aggregated team outcomes, including two role stressors (i.e., role ambiguity and role overload) and two indicators of well-being (i.e., quality of worklife and distress). Questionnaires were distributed in an Australian law enforcement agency and data were used from 178 teams. Structural equation modelling analyses, controlling for a marker variable, were conducted to examine the main effects of aggregated change information and aggregated change participation on aggregated team outcomes. Results provided support for a model that included method effects due to a marker variable. In this model, change information climate was significantly negatively associated with role ambiguity, role overload, and distress, and significantly positively associated with quality of worklife. Change participation climate was significantly positively associated with quality of worklife. Change climate strength did not moderate relationships among change climate level and team outcomes.     

Therapeutic processes in group therapy: Intersections between general change mechanisms and motivational stages of change from patient perspective

Intersections between Grawe’s General Psychotherapy and Prochaska’s Transtheoretical Model were investigated in group therapy in a longitudinal design. It was assumed that general change mechanisms have an impact on patients’ stages of change. Specifically, the main hypotheses were that experiential change mechanisms (ECM; clarification of meaning, problem actuation, emotional bond and group cohesion) should be especially relevant for early stages of change (precontemplation and contemplation), whereas behavioral change mechanisms (BCM; resource activation, mastery/coping and task and goals) should be especially relevant for late stages of change (action and maintenance). Therefore, 140 outpatients attending different types of group therapy, with a typical duration of 8 sessions, were investigated. Patients completed the Form for the Evaluation of Therapeutic Processes in Group Therapy (FEPiG), the University of Rhode Island Change Assessment, short version (URICA-S) and several symptomatology measures (BDI-II, BSCL and IIP-32) at two measuring times. Intersections were analysed through correlational analyses, cross-lagged panels and a path-analytic model, supporting the hypotheses. Specifically, results suggested that experiencing ECM at t1 predicted higher levels of reported contemplation at t2. Patients experiencing higher levels of BCM at t1 reported higher levels of action at t2. Clinical implications of the results are discussed.     

Appearance investment mediates the association between fear of negative evaluation and dietary restraint

This study investigated whether appearance investment explains the association between fear of negative evaluation and dietary restraint. Data were collected from 305 undergraduate female participants in an online survey. Mediation analyses were conducted using Preacher and Hayes (2008) Indirect Mediation macro. Results showed that both components of appearance investment that is, holding appearance as central to self-definition and the tendency to engage in appearance management behaviours, mediate the association between fear of negative evaluation and dietary restraint. The Baron and Kenny (1986) method further showed that holding appearance as central to self-definition fully mediates this association but that engagement in appearance management behaviours only partially mediates it. These results suggest that appearance investment could prompt women to diet to try to lose weight to fend off feared negative evaluation from others.     

The contributions of Rosenbaum's model of self-control and the transtheoretical model to the understanding of exercise behavior

ObjectivesRosenbaum's [1990. The role of learned resourcefulness in the self-control of health behavior. In M. Rosenbaum (Ed.), Learned resourcefulness: On coping skills, self-control, and adaptive behavior (pp. 3–30). New York: Springer Publishing Company; 2000. The self-regulation of experience: openness and construction. In P. Dewe, A. M. Leiter, &; T. Cox (Eds.), Coping and health in organizations (pp. 51–67). London: Taylor and Francis] model of self-control depicts learned resourcefulness as a key component of the goal attainment process. Despite this model's popularity, few studies have examined its importance in the maintenance of exercise. The transtheoretical model of change has been used instead. The two models, nonetheless, share strikingly similar components with the exception of learned resourcefulness.Design/MethodsOur 265 participants, ranging from wanting to be active to being regular exercisers, completed instruments assessing learned resourcefulness, stage of change for exercise, self-efficacy, reasons for exercising and the processes of change for exercise.ResultsAs predicted, participants in the maintenance stage for exercise were on average more highly resourceful than participants in the contemplation, preparation and action stages of change. Low resourceful participants in the contemplation stage of change were the least likely to be employing strategies to help facilitate activity.ConclusionImplications for exercise promoters are discussed.     

Bridging professional and mutual-help: An application of the transtheoretical model to the mutual-help organization

The authors suggest that the mental health system of the nation could benefit by more fully embracing the idea of mutual-help (i.e., self-help), and this collaboration could be facilitated by the utilization of a well-established clinical theory to elucidate the psychological processes at work within mutual-help organizations. The processes of change of the transtheoretical model is offered as one potential framework. This well-established model has been used to help psychologists better understand clinical and professional phenemonena, but, to date, has been used less frequently with non-professional interventions. This article applies the ten processes of change of the transtheoretical model to mutual-help organizations, focusing on four groups, including Alcoholics Anonymous (AA), Oxford House, GROW, and Schizophrenics Anonymous. The advantages of the transtheoretical model and its potential ability to act as a common language across clinical professionals and mutual-help organizations are discussed. In addition, advantages of bolstering the present mental health system using combinations of both forms of care along the recovery continuum are described.     

Hide-and-seek around the centre of interest: The dead zone of attention revealed by change blindness

Three experiments examined spatial allocation of attention during active search for visual changes. In all experiments, there were three conditions of change location related to a centre of interest: (1) Central (most attended location itself), (2) near, and (3) far marginal change. In Experiment 1, participants showed the slowest search and the largest number of undetected changes in near condition. Moreover, they misidentified near changes more frequently than central and far ones. In Experiment 2, participants had to search for marginal changes in the presence of a once noticed central change that summoned additional attention to a central location. It resulted in further search slowing for near changes. In Experiment 3, participants searched for one of two concurrent marginal changes in the presence of a central one. They detected far changes about 2.3 times more frequently than near ones. Taken together, these results support the notion of “dead zone of attention” surrounding attentional focus. Several speculations about the nature of dead zone are discussed.     

And deplete us not into temptation: Automatic attitudes, dietary restraint, and self-regulatory resources as determinants of eating behavior

Linking contemporary models of self-regulation to recent research on automatic attitudes, the present study investigated the impact of automatic candy attitudes, dietary restraint standards, and self-regulation resources on eating behavior. Participants were assigned to either an emotion suppression task (low self-regulation resources) or an emotion flow task (high self-regulation resources), and were then given an opportunity to taste candies. When self-regulation resources were high, candy consumption was uniquely related to dietary restraint standards (but not automatic candy attitudes). In contrast, when self-regulation resources were low, candy consumption was primarily predicted by automatic candy attitudes, with dietary restraint standards showing a tendency for counterintentional effects. These results indicate that the behavioral impact of automatic attitudes and personal standards depends on available control resources. Implications for research on automatic attitudes and self-regulation are discussed.     

Predicting uptake of a routine cervical smear test: A comparison of the health belief model and the theory of planned behaviour

Abstract

This paper reports on a study carried out to identify predictors of uptake of cervical screening among 142 women (59% response rate) in inner London. Two social cognition models were used: The Health Belief Model (HBM; Becker, 1974) and the Theory of Planned Behaviour (TPB; Ajzen, 1991) and in addition anticipated affect following non-attendance for screening was assessed. The TPB emerged as by far the superior model for predicting screening intentions, explaining 51% of the variance in comparison with only 4% explained by the HBM variables. However, neither model was able to predict a significant amount of variance in uptake of screening three months later. Possible reasons for the poor prediction of this type of behaviour are discussed.     

An extension of the partial credit model with an application to the measurement of change

The partial credit model is considered under the assumption of a certain linear decomposition of the item × category parameters _ih into basic parameters _j. This model is referred to as the linear partial credit model. A conditional maximum likelihood algorithm for estimation of the j is presented, based on (a) recurrences for the combinatorial functions involved, and (b) using a quasi-Newton approach, the so-called Broyden-Fletcher-Goldfarb-Shanno (BFGS) method; (a) guarantees numerically stable results, (b) avoids the direct computation of the Hesse matrix, yet produces a sequence of certain positive definite matricesB _k ,k=1, 2, ..., converging to the asymptotic variance-covariance matrix of the . The practicality of these numerical methods is demonstrated both by means of simulations and of an empirical application to the measurement of treatment effects in patients with psychosomatic disorders.The authors thank one anonymous reviewer for his constructive comments. Moreover, they thankfully acknowledge financial support by the Österreichische Nationalbank (Austrian National Bank) under Grant No. 3720.     

Accuracy in estimating the body weight of self and others: Impact of dietary restraint and BMI

We examined the accuracy of people's estimates of their own body weight and of the body weight of other people. Female undergraduates (n = 132) self-reported their weight, were weighed by the experimenter, and completed a measure of dietary restraint. Participants also viewed 10 photographs of women ranging from underweight to obese and estimated their body weight. Individuals high in dietary restraint underestimated their own weight to a greater extent than those low in dietary restraint, but this effect was accounted for by individual differences in BMI: heavier participants underestimated their weight to a greater extent than leaner participants. Participants also underestimated the weight of heavier targets to a greater extent than they did leaner targets, but the degree of inaccuracy was not related to participants’ dietary restraint or BMI. These findings support the hypothesis that inaccuracies in self-reported weight reflect deliberate misreporting rather than a cognitive or perceptual bias.