The Contribution of Hope and Affectivity to Diabetes-Related Disability: An Exploratory Study

This study examined the relationships of the dispositional variables of hope, positive affectivity (PA), and negative affectivity (NA) with disease status and illness-related psychosocial functioning in a sample of 45 young adults with insulin-dependent diabetes mellitus (IDDM). Canonical analyses revealed one significant canonical function between the dispositional and psychosocial outcome variables. Primary contributors to the relationship were higher NA and lower PA and maladaptive emotional behavior. A linear multiple regression analysis using hope and affectivity as predictors failed to account for a significant proportion of variance in objective disease status as measured by hemoglobin A _1C (HbA_1C). The results support previous findings that affectivity may relate to self-reported, disease-related outcome, but not necessarily to objective measures of health status. Future studies of adaptation to chronic illness should consider including measures of illness-related behaviors (e.g., adherence), as well as subjective and objective measures of health status.     

Perception de la maladie et adhérence thérapeutique chez des enfants asthmatiques

This study had two objectives. The first one was to adapt and validate the Revised-Illness Perception Questionnaire (IPQ-R) for children and their parents. The second one was to assess the influence of parent's and children's asthma perception and parent's involvement in treatment on adherence among children suffering asthma. One hundred and forty-six asthmatic children (8–12 years old) and ninety-two parents completed the Revised-Illness Perception Questionnaire and a therapeutic adherence scale. Children who have a good understanding of their illness and who think that their treatment control their asthma, have a better therapeutic adherence. The originality of this research lies in the use of the Illness Perception Questionnaire among children; this could be used in other chronic pediatric diseases.     

Prospective Examination of Self‐Regulatory Efficacy in Predicting Walking for Active Transportation: A Social Cognitive Theory Approach

Walking for transportation is associated with health benefits. Minimal theory‐based research has examined social cognitive and environmental predictors. This study examined social cognitions (self‐regulatory efficacy to plan/schedule and overcome barriers; distance and travel time cognitions) and an environmental factor (proximity) as predictors of walking for transportation. Participants (n = 105) were university students, faculty, and staff, living within a walkable distance to campus. Social cognitions and proximity measures were completed at baseline, followed by walking for transportation to/from the campus over 2 weeks. A hierarchical multiple regression analysis predicted walking (R²_adjusted = .55; p < .05). Self‐regulatory efficacy to plan/schedule and overcome barriers were independent predictors (p's < .01). Findings supported theoretical contentions that self‐regulatory efficacy predicts walking for transportation.     

Physical and Psychological Health Predict Adherence to an Online Mindfulness Program for College Students

We examined predictors of students' adherence to a 10-session online mindfulness program. Undergraduates naive to meditation (N = 169) were recruited from an introductory psychology subject pool. Students completed assessments examining physical and psychological health and were asked to complete a 10-session online mindfulness activity. More than half (53%) of the sample was fully adherent to the program. Better physical health and lower levels of anxiety predicted adherence. We present recommendations for increasing adherence in the clinical use of mindfulness with college students.     

Illness perceptions and self efficacy beliefs in adolescents and young adults with insulin dependent diabetes mellitus

Abstract

The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific self-efficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.     

Examining the components of children's peer liking as antecedents of school adjustment

Children's social interactions with their peers influence their psychosocial adjustment; consequently, the relationship between class‐wide peer liking, same‐gender peer liking, and school adjustment was explored in two age groups. Peer liking was analysed using the social relations model (SRM). In Study 1, 205 children (103 female and 102 male, M_age= 7.15, SD= 7 months) completed measures of peer liking and school adjustment, and teachers completed the Short‐Form Teacher Rating Scale of School Adjustment (Short‐Form TRSSA). In Study 2, 197 children (98 female and 90 male, M_age= 9.87, SD= 5.9 months) completed measures of peer liking and school adjustment. Both studies yielded evidence of reciprocal liking and individual differences in the ratings of liking awarded to, and elicited from, both peer groups. Multigroup path analysis, with groups created according to gender, revealed that elements of liking predicted different aspects of school adjustment with some variation according to age and gender. Together, these findings suggest that the SRM can be used to examine peer liking and underscore the importance of children's peers for school adjustment.     

Strengths of character,orientations to happiness,and life satisfaction

Why are certain character strengths more associated with life satisfaction than others? A sample of US adults (N?=?12,439) completed online surveys in English measuring character strengths, orientations to happiness (engagement, pleasure, and meaning), and life satisfaction, and a sample of Swiss adults (N?=?445) completed paper-and-pencil versions of the same surveys in German. In both samples, the character strengths most highly linked to life satisfaction included love, hope, curiosity, and zest. Gratitude was among the most robust predictors of life satisfaction in the US sample, whereas perseverance was among the most robust predictors in the Swiss sample. In both samples, the strengths of character most associated with life satisfaction were associated with orientations to pleasure, to engagement, and to meaning, implying that the most fulfilling character strengths are those that make possible a full life.     

Illness representations predict adherence in adolescents and young adults with type 1 diabetes

Objective: Most adolescents and young adults (AYAs) with type 1 diabetes struggle with diabetes self-management and exhibit suboptimal glycemic control. This study examined two models of association between illness representations, a modifiable predictor of suboptimal outcomes, and adherence and glycemic control in AYAs with type 1 diabetes.

Design and main outcome measures: Ninety-nine AYAs (ages 15–20?years) completed measures of illness representations and adherence at two visits. Blood glucose monitoring frequency and haemoglobin A1c were obtained via chart review. Relationships were examined using structural equation modelling.

Results: Illness representations accounted for a significant proportion of the variance in blood glucose monitoring frequency (ΔR^2?=?.23, p?<?.01) and adherence to emergency precautions at Time 1 (ΔR^2?=?.07, p?=?.03). Illness representations also accounted for significant variance in blood glucose monitoring frequency (ΔR^2?=?.08, p?=?.01), adherence to recommendations for insulin and food (ΔR²?=?.08, p?=?.02) and exercise (ΔR^2?=?.10, p?<?.01), and adherence to emergency precautions (ΔR^2?=?.16, p?<?.01) at Time 2.

Conclusion: Illness representations are salient predictors of adherence in this population. Interventions targeting adherence promotion and glycemic control in AYAs with type 1 diabetes may be enhanced by efforts to modify illness representations.     

Conscientiousness and adherence to the oral contraceptive pill: A prospective study

Objective: We assess the association between conscientiousness and adherence to the oral contraceptive pill (OCP), and examine if such a relationship is independent of a measure of prospective memory and a range of social cognitive variables.

Method: Data were collected from 150 OCP users at baseline, and 99 provided follow-up data four weeks later. Conscientiousness, a range of social cognitive predictors and prospective memory were assessed at baseline. OCP adherence was measured at baseline, and again at Time 2. Data were analysed using correlation and multiple linear regression.

Results: Higher conscientiousness was associated with higher overall OCP adherence in both cross-sectional (r = ?0.28, p < 0.01) and prospective analysis (r = ?0.34, p < 0.01). Conscientiousness predicted OCP adherence at Time 2, adjusting for OCP adherence at Time 1 (R² change = 0.02, p = 0.04). The association was reduced to non-significance when social cognitive predictors and prospective memory were included in the multivariable model. Prospective memory was an independent predictor of OCP adherence at Time 2.

Discussion: This is the first study to identify an association between conscientiousness and OCP adherence. The association is not independent from social cognitive predictors and prospective memory. Facet-level analysis of conscientiousness and formal mediation analyses are recommended in future replications.     

Explanatory,Multilevel Person-Fit Analysis of Response Consistency on the Spielberger State-Trait Anxiety Inventory

Self-report measures are vulnerable to concentration and motivation problems, leading to responses that may be inconsistent with the respondent's latent trait value. We investigated response consistency in a sample (N = 860) of cardiac patients with an implantable cardioverter defibrillator and their partners who completed the Spielberger State-Trait Anxiety Inventory on five measurement occasions. For each occasion and for both the state and trait subscales, we used the l ^p _z person-fit statistic to assess response consistency. We used multilevel analysis to model the between-person and within-person differences in the repeated observations of response consistency using time-dependent (e.g., mood states) and time-invariant explanatory variables (e.g., demographic characteristics). Respondents with lower education, undergoing psychological treatment, and with more post-traumatic stress disorder symptoms tended to respond less consistently. The percentages of explained variance in response consistency were small. Hence, we conclude that the results give insight into the causes of response inconsistency but that the identified explanatory variables are of limited practical value for identifying respondents at risk of producing invalid test results. We discuss explanations for the small percentage of explained variance and suggest alternative methods for studying causes of response inconsistency.     

Cohen's d Corrected for Case IV Range Restriction: A More Accurate Procedure for Evaluating Subgroup Differences in Organizational Research

Organizational and staffing researchers are often interested in evaluating whether subgroup differences exist (e.g., between Caucasian and African‐American individuals) on predictors of job performance. To investigate subgroup differences, researchers often will collect data from current employees to make inferences about subgroup differences among job applicants. However, the magnitude of subgroup differences (i.e., Cohen's d) within incumbent samples may be different (i.e., smaller) than the magnitude of subgroup differences in applicant samples because selection of applicants typically reduces the variance of scores on the predictors (i.e., because lower scoring applicants are not selected). If researchers seek to generalize a d value in an incumbent sample to the applicant population, they may use Bobko, Roth, and Bobko's (correcting the effect size of d for range restriction and unreliability, 2001) Case II or III correction. By extension, Hunter, Schmidt, and Le (implications of direct and indirect range restriction for meta‐analysis methods and findings, 2006) have proposed a Case IV correction, which is more realistic than Bobko et al.'s approach. Therefore, this paper develops a Case IV correction for d (i.e., d_c4). The simulation results showed that the d_c4 was generally accurate across 6,000 simulation conditions. Moreover, 2 published datasets were reanalyzed to show the influence of the Case IV correction on d. In addition, implications and future directions of the d_c4 are discussed.     

Breast cancer: The intention to have a mammography and a clinical breast examination - application of the theory of planned behavior

Abstract

The purpose of these cross sectional studies was to identify the psychosocial factors explaining women's intention to have a mammography within the next two years and their intention to have a clinical breast examination (CBE) by a professional within the next year. Two random samples of women aged 40–69 years (n_a = 354, n_b = 344) completed a self-administered questionnaire that investigated theoretical constructs of the theory of planned behavior. The results of structural equation modeling showed that subjective norms and perceived behavioral control explained 81 % of the variance in intention of having a mammography. Sixty-five percent (65%) of the variance in intention of having a CBE was explained by attitude and perceived behavioral control. In conclusion, women need to be better informed, have better skills to overcome psychological and physical barriers in performing preventive breast behaviors, and promotion of preventive breast cancer methods should consider people significant for women.     

Robust step‐down tests for multivariate independent group designs

A composite step‐down procedure, in which a set of step‐down tests are summarized collectively with Fisher's combination statistic, was considered to test for multivariate mean equality in two‐group designs. An approximate degrees of freedom (ADF) composite procedure based on trimmed/Winsorized estimators and a non‐pooled estimate of error variance is proposed, and compared to a composite procedure based on trimmed/Winsorized estimators and a pooled estimate of error variance. The step‐down procedures were also compared to Hotelling's T² and Johansen's ADF global procedure based on trimmed estimators in a simulation study. Type I error rates of the pooled step‐down procedure were sensitive to covariance heterogeneity in unbalanced designs; error rates were similar to those of Hotelling's T² across all of the investigated conditions. Type I error rates of the ADF composite step‐down procedure were insensitive to covariance heterogeneity and less sensitive to the number of dependent variables when sample size was small than error rates of Johansen's test. The ADF composite step‐down procedure is recommended for testing hypotheses of mean equality in two‐group designs except when the data are sampled from populations with different degrees of multivariate skewness.     

Identifying the Source of Misfit in Item Response Theory Models

When an item response theory model fails to fit adequately, the items for which the model provides a good fit and those for which it does not must be determined. To this end, we compare the performance of several fit statistics for item pairs with known asymptotic distributions under maximum likelihood estimation of the item parameters: (a) a mean and variance adjustment to bivariate Pearson's X², (b) a bivariate subtable analog to Reiser's (1996) overall goodness-of-fit test, (c) a z statistic for the bivariate residual cross product, and (d) Maydeu-Olivares and Joe's (2006) M₂ statistic applied to bivariate subtables. The unadjusted Pearson's X² with heuristically determined degrees of freedom is also included in the comparison. For binary and ordinal data, our simulation results suggest that the z statistic has the best Type I error and power behavior among all the statistics under investigation when the observed information matrix is used in its computation. However, if one has to use the cross-product information, the mean and variance adjusted X² is recommended. We illustrate the use of pairwise fit statistics in 2 real-data examples and discuss possible extensions of the current research in various directions.     

Medication beliefs and structural barriers to treatment adherence among people living with HIV infection

Background: People living in poverty face multiple structural challenges to medication adherence including lack of transportation, inadequate housing and food insecurity. The degree to which individuals’ motivations to remain adherent may overcome structural barriers has received limited attention.

Purpose: To examine whether medication necessity and concerns beliefs predict antiretroviral therapy (ART) adherence over and above structural adherence barriers associated with poverty.

Methods: People living with HIV in a southern US city (N = 942) completed computerised interviews, an objective measure of adherence and HIV viral suppression obtained from medical records. Hierarchical logistic regression models were constructed to examine demographic and illness characteristics, structural barriers, mental health, substance use and medication necessity and concerns beliefs as predictors of ART adherence.

Results: In multivariable models, current drug use and medication necessity and concerns beliefs predicted treatment adherence over and above demographic, health, mental health and structural factors.

Conclusions: Medication beliefs are proximal and powerful motivating factors that predict adherence. Adherence interventions should directly address medication beliefs in developing strategies to manage barriers facing people with HIV living in poverty.     

Explaining Delay in Care Seeking for Breast Cancer Symptoms1

From a theory of care-seeking behavior, this study answered two questions: Do psychosocial variables (anxiety, utility, norm, and habit) and objective, facilitating conditions (e. g., regular practitioner) influence care-seeking delay with a breast symptom directly, or are psychosocial influences moderated by facilitating conditions? Do demographic or clinical factors explain delay, controlling for psychosocial variables and facilitating conditions? Women with breast cancer symptoms (N= 106) completed questionnaire measures. Delay was measured by the days between symptom detection and first contact with the health system. Norm and having a regular practitioner were related inversely to delay. The influence of anxiety was moderated by having a regular practitioner. Among women lacking a practitioner, anxiety was related inversely to delay; among women with a practitioner, anxiety was not related to delay. Controlling for psychosocial variables and facilitating conditions, women of color delayed longer than did Caucasians. Findings can guide research and theory about care seeking.     

Anxiety and Asthma Symptoms in Urban Adolescents with Asthma: The Mediating Role of Illness Perceptions

Twenty to 40% of adolescents with asthma experience significant symptoms of anxiety. This study examined the mediational role of illness perceptions in the relationship between anxiety and asthma symptoms in adolescents. One hundred fifty-one urban adolescents (ages 11–18) with asthma completed measures of illness perceptions, and anxiety and asthma symptoms. Using the Baron and Kenny approach and Sobel tests, we examined whether illness perceptions mediated the anxiety-asthma symptom relationship. Three illness perceptions significantly mediated the relationship between anxiety and asthma symptoms, z = 1.97–2.13, p < .05; adjusted R ² = 0.42–0.51, p < .05. Greater anxiety symptoms were associated with perceptions that asthma negatively impacted one’s life and emotions and was difficult to control. These negative illness perceptions were, in turn, related to greater asthma symptoms. Illness perceptions helped explain the anxiety-asthma symptoms link in adolescents. Results suggest that targeting illness perceptions in adolescents with asthma and anxiety may help reduce asthma symptoms.     

Utility of the Millon Behavioral Medicine Diagnostic to Predict Medication Adherence in Patients Diagnosed with Heart Failure

Medication non-adherence is common and a primary reason for poor medical outcomes among individuals with heart failure (HF). This study's aims were to determine whether depression, hostility, and the personality-based Millon Behavioral Medicine Diagnostic (MBMD) Medication Abuse scale were associated with medication adherence (e.g., beta-blockers, ACE inhibitors, diuretics, statins) beyond contributions of demographic, medical, and psychosocial variables in an ethnically-diverse sample of 105 men and women diagnosed with HF. In hierarchical regression, greater MBMD Medication Abuse scale scores were associated with poorer adherence above and beyond both depression (β?=?.236, t[102]?=?2.113, p?=?.037) and hostility (β?=?.244, t[102]?=?2.506, p?=?.014). The Medication Abuse scale also completely mediated the relationship between adherence and depression. These findings suggest that personality measures such as the MBMD and hostility scales might be utilized in future studies investigating predictors of adherence and also used clinically to predict medication adherence among HF patients.