Psychological resources, positive illusions, and health

Psychological beliefs such as optimism, personal control, and a sense of meaning are known to be protective of mental health. Are they protective of physical health as well? The authors present a program of research that has tested the implications of cognitive adaptation theory and research on positive illusions for the relation of positive beliefs to disease progression among men infected with HIV. The investigations have revealed that even unrealistically optimistic beliefs about the future may be health protective. The ability to find meaning in the experience is also associated with a less rapid course of illness. Taken together, the research suggests that psychological beliefs such as meaning, control, and optimism act as resources, which may not only preserve mental health in the context of traumatic or life-threatening events but be protective of physical health as well.     

Effect of Direct-to-Consumer Genetic Tests on Health Behaviour and Anxiety: A Survey of Consumers and Potential Consumers

Direct-to-consumer (DTC) genetic tests can be purchased over the internet. Some companies claim to provide relative genetic risks for various diseases and thus encourage healthy behaviour. There are concerns that exposure to such information may actually discourage healthy behaviour or increase health anxiety. An online survey was conducted (n?=?275). Respondents were composed of individuals who had purchased a DTC genetic test and received their results (consumers, n?=?189), as well as individuals who were either awaiting test results or considering purchasing a test (potential consumers, n?=?86). Consumers were asked if their health behaviour or health anxiety had changed after receiving their results. Respondents’ current health behaviour and health anxiety were queried and compared. In total, 27.3 % of consumers claimed a change in health behaviour, all either positive or neutral, with no reported cessation of any existing health behaviour. A change in health anxiety was claimed by 24.6 % of consumers, 85.3 % of which were a reduction. Consumers had significantly better health behaviour scores than potential consumers (p?=?0.02), with no significant difference in health anxiety. This study points towards an association between receipt of DTC genetic test results and increased adoption of healthy behaviours for a minority of consumers based on self-report, with more mixed results in relation to health anxiety.     

‘I feel better when…’: An analysis of the memory-experience gap for peoples’ estimates of the relationship between health behaviours and experiences

Objective: People often overestimate how strongly behaviours and experiences are related. This memory-experience gap might have important implications for health care settings, which often require people to estimate associations, such as “my mood is better when I exercise”. This study examines how subjective correlation estimates between health behaviours and experiences relate to calculated correlations from online reports and whether subjective estimates are associated with engagement in actual health behaviour.

Design: Seven-month online study on physical activity, sleep, affect and stress, with 61 online assessments.

Main Outcome Measures: University students (N = 168) retrospectively estimated correlations between physical activity, sleep, positive affect and stress over the seven-month study period.

Results: Correlations between experiences and behaviours (online data) were small (r = ?.12–.14), estimated correlations moderate (r = ?.35–.24). Correspondence between calculated and estimated correlations was low. Importantly, estimated correlations of physical activity with stress, positive affect and sleep were associated with actual engagement in physical activity.

Conclusion: Estimation accuracy of relations between health behaviours and experiences is low. However, association estimates could be an important predictor of actual health behaviours. This study identifies and quantifies estimation inaccuracies in health behaviours and points towards potential systematic biases in health settings, which might seriously impair intervention efficacy.     

Happiness,health, and religiosity: significant associations among Lebanese adolescents

The present study sought to test for an association between, and sex-related differences in, happiness, health, and religiosity. A sample (N?=?239) of Lebanese adolescents was recruited (111 boys and 128 girls). They responded to the Oxford Happiness Inventory, the Satisfaction with Life Scale, the Love of Life Scale as well as five self-rating scales to assess happiness, satisfaction, mental health, physical health, and religiosity. Boys obtained a higher mean score on mental health than did their female counterparts. All the Pearson correlations between the study scales were significant and positive but two. Principal components analysis yielded two salient components in boys and labelled “Happiness”, and “Religiosity and health”. In girls, only one component was retained, and labelled “Happiness, health, and religiosity”. It was concluded that those consider themselves as enjoying happiness, experienced good mental and physical health and more religious.     

Multiple health risk behaviours and posttraumatic stress disorder symptoms among university students from 22 countries

The goal of the study was to investigate multiple health risk behaviours in relation to PTSD symptoms in a sample of university students from 22 countries. Using anonymous questionnaires, data were collected from 16804 undergraduate university students (mean age 20.8, SD?=?2.8) from 23 universities in 22 countries in Africa, Asia, Caribbean and South America. Results indicate that overall, 20.9% of the university students screened positive for PTSD, and the overall mean of health risk behaviours (range from 1–10) was 2.7 for university students from all countries. Logistic regression adjusted for sociodemographic characteristics and social support found that each of the ten individual health risk behaviours was significantly associated with PTSD symptoms. In addition, logistic regression with multiple health risk behaviours found a steady increase from 1 (Odds Ratio (OR): 1.37, CI 1.05–1.77) to 5 or more (OR: 3.57, CI 2.75–4.64) health risk behaviours in association with PTSD symptoms, adjusted for age, gender, economic family background and social support.     

Investigating the predictive validity of implicit and explicit measures of motivation on condom use, physical activity and healthy eating

The literature on health-related behaviours and motivation is replete with research involving explicit processes and their relations with intentions and behaviour. Recently, interest has been focused on the impact of implicit processes and measures on health-related behaviours. Dual-systems models have been proposed to provide a framework for understanding the effects of explicit or deliberative and implicit or impulsive processes on health behaviours. Informed by a dual-systems approach and self-determination theory, the aim of this study was to test the effects of implicit and explicit motivation on three health-related behaviours in a sample of undergraduate students (N?=?162). Implicit motives were hypothesised to predict behaviour independent of intentions while explicit motives would be mediated by intentions. Regression analyses indicated that implicit motivation predicted physical activity behaviour only. Across all behaviours, intention mediated the effects of explicit motivational variables from self-determination theory. This study provides limited support for dual-systems models and the role of implicit motivation in the prediction of health-related behaviour. Suggestions for future research into the role of implicit processes in motivation are outlined.     

Investigating the predictive validity of implicit and explicit measures of motivation on condom use,physical activity and healthy eating

The literature on health-related behaviours and motivation is replete with research involving explicit processes and their relations with intentions and behaviour. Recently, interest has been focused on the impact of implicit processes and measures on health-related behaviours. Dual-systems models have been proposed to provide a framework for understanding the effects of explicit or deliberative and implicit or impulsive processes on health behaviours. Informed by a dual-systems approach and self-determination theory, the aim of this study was to test the effects of implicit and explicit motivation on three health-related behaviours in a sample of undergraduate students (N?=?162). Implicit motives were hypothesised to predict behaviour independent of intentions while explicit motives would be mediated by intentions. Regression analyses indicated that implicit motivation predicted physical activity behaviour only. Across all behaviours, intention mediated the effects of explicit motivational variables from self-determination theory. This study provides limited support for dual-systems models and the role of implicit motivation in the prediction of health-related behaviour. Suggestions for future research into the role of implicit processes in motivation are outlined.     

Clustering of diet,physical activity and smoking and a general willingness to change

Addressing multiple health behaviours are important in preventing disease and mortality. The present study investigated the clustering of health behaviours, cognitive determinants and stages of change in 2827 adults for the lifestyle factors of physical activity, fruit, vegetable and fat consumption and smoking. The results showed that only 3% of the total population met recommended guidelines for all of the five behaviours. Behaviours were found to be weakly associated. Behaviour-specific cognitions and stages of change for the behaviours clustered more strongly, however. With respect to diet and physical activity, respondents in the preparation stage for one behaviour were likely also to be preparing to change another behaviour. Possible mechanisms for the apparent general willingness to change multiple behaviours are discussed, as well as potential implications for health promotion practice.     

Behaviour change among overweight and socially disadvantaged adults: A longitudinal study of the NHS Health Trainer Service

Social disadvantage is associated with being overweight, a poor diet and physical inactivity. The NHS Health Trainer Service (HTS) is a national initiative designed to promote behaviour change among socially disadvantaged people in England and Wales. This study reports pre–post changes in Body Mass Index (BMI), associated behaviours and cognitions among service users who set dietary or physical activity goals during a 12-month period (2008–2009; N?=?4418). Sixty-nine percent of clients were from the two most deprived population quintiles and 94.7% were overweight or obese. Mean BMI decreased from 34.03 to 32.26, with overweight/obesity prevalence decreasing by 3.7%. There were increases in fruit and vegetable consumption, reductions in fried snack consumption, increases in frequency of moderate or intensive activity and gains in self-efficacy and perceived health and wellbeing. Clients with higher BMI, poorer diet or less activity at baseline achieved greater change. Findings suggest that the NHS HTS has the potential to improve population health and reduce health inequalities through behaviour change.     

Change in Maternal Stress for Families in Treatment for their Children with Oppositional Defiant Disorder

Our objective was to predict change in maternal stress over the course of a randomized clinical trial comparing the efficacy of two interventions for Oppositional Defiant Disorder (ODD): Parent Management Training and Collaborative & Proactive Solutions. In a secondary analysis of data collected from this randomized clinical trial, we examined whether children’s self-reported positive relations with their parents impacted responsiveness to treatment, which in turn impacted maternal stress. One hundred thirty-four children and their parents (38.1% female, ages 7–14, M age?=?9.51, SD?=?1.77) were tracked across three time points: pre-treatment; one-week post-treatment; and six-month post-treatment. Hierarchical linear models tested change in children’s reports of positive relations with parents, clinician reports of ODD severity, and maternal reports of parenting stress. Models then tested multilevel mediation from positive relations with parents, through ODD severity, onto maternal stress. Hypothesized indirect effects were supported such that children’s reports of positive views toward parents uniquely predicted reductions in ODD severity over time, which in turn uniquely predicted reductions in maternal stress. Results highlight the promise of potential secondary benefits for parents following interventions for children with oppositional problems. Furthermore, results underscore the importance of the parent–child relationship as both a protective factor and as an additional target to complement interventions for child disruptive behaviors.     

Psychological correlates of negative self-assessed health

The recent growth in the area now subsumed under the title health psychology can be seen to reflect real changes in the societal pre-occupation with health promotion. Established models within health psychology have tended to focus on the interface between the individual and the health care system. Moreover, as a consequence of employing the tripartite model of health, illness and sick-role behaviour as separate entities, research has tended to construct barriers between these behaviours. In is necessary to develop psychological models within health psychology rather than use the education model of the medical orthodoxy. This study explored the distinguishing features of a sub-group of women within the sample who were identified as having relatively negative self-assessed health. Data was obtained on their experience of health and illness, their involvement in health-related behaviours (HRB) and their health beliefs. It was shown that this group was more likely to be involved in damaging HRB, but involvement in positive HRB did not differ from the main sample. They tended to anticipate an improvement over time from their present health status which they felt had been influenced by their own behaviour and by their experience of motherhood.     

Nigerian Clergy and healthcare professionals’ perceptions of health-seeking behaviours among Nigerian immigrants in the UK

The diversity in patient populations due to immigration in the UK has implications for adequate understanding of a patients’ culture by the clinician as well as patient–clinician cultural matching for enhanced service use and outcome. This qualitative study investigated how Nigerian clergy and health professionals perceived health-seeking behaviours among Nigerians in the UK, while considering the impact of their own beliefs and values as care providers. Six participants were interviewed (clergy, n?=?2; health professionals, n?=?4). Data were analysed using Interpretative Phenomenological Analysis. Results showed that the clergy and health professionals themselves use religious/cultural cure and formal healthcare methods, and believed Nigerian immigrants as predominantly using religious/cultural methods which can affect healthcare utilisation, although differences between the professionals were reported. The potentials for integrating other cure methods into the formal healthcare services were considered, while highlighting the challenges that may arise from such collaborative effort.     

Behaviour change among overweight and socially disadvantaged adults: a longitudinal study of the NHS Health Trainer Service

Social disadvantage is associated with being overweight, a poor diet and physical inactivity. The NHS Health Trainer Service (HTS) is a national initiative designed to promote behaviour change among socially disadvantaged people in England and Wales. This study reports pre-post changes in body mass index (BMI), associated behaviours and cognitions among service users who set dietary or physical activity goals during a 12-month period (2008-2009; N?=?4418). Sixty-nine percent of clients were from the two most deprived population quintiles and 94.7% were overweight or obese. Mean BMI decreased from 34.03 to 32.26, with overweight/obesity prevalence decreasing by 3.7%. There were increases in fruit and vegetable consumption, reductions in fried snack consumption, increases in frequency of moderate or intensive activity and gains in self-efficacy and perceived health and wellbeing. Clients with higher BMI, poorer diet or less activity at baseline achieved greater change. Findings suggest that the NHS HTS has the potential to improve population health and reduce health inequalities through behaviour change.     

The bidirectional relation between positive mental health and psychopathology in a longitudinal representative panel study

Background: There is accumulating evidence that positive mental health and psychopathology should be seen as separate indicators of mental health. This study contributes to this evidence by investigating the bidirectional relation between positive mental health and psychopathological symptoms over time. Methods: Positive mental health (MHC-SF) and psychopathological symptoms (BSI) were longitudinally measured in a representative adult sample (N?=?1932) on four measurement occasions in nine months. A cross-lagged panel design was applied and evaluated with a latent growth model combined with an item response theory measurement model. Results: Psychopathological symptoms were longitudinally related to positive mental health and vice versa, controlling for initial levels. The changes over time were even more important than the absolute levels of psychopathological symptoms and positive mental health, respectively. Conclusions: The results underline the need for a comprehensive perspective on mental health, incorporating both the treatment of symptoms and the enhancement of well-being.     

The Benefits of Goal Adjustment Capacities for Well‐Being Among Women With Breast Cancer: Potential Mechanisms of Action

Breast cancer can seriously disrupt a person's important life goals. As such, the ability to adjust one's goals may be critical for well‐being. The present study investigated the relationships between disengagement/reengagement capacity and well‐being among women with breast cancer, as well as several potential mechanisms (intrusive thoughts, life purpose, and physical activity) that could explain these relationships. The sample consisted of 230 women with early‐stage (n = 172) or late‐stage (n = 58) breast cancer, who were followed prospectively for 8 months. Well‐being measures consisted of global mental health, perceived physical health, positive/negative affect, and sleep efficiency. Disengagement capacity did not predict any outcome variable. In contrast, reengagement capacity prospectively predicted changes in global mental health, positive affect, negative affect, sleep efficiency, life purpose, and physical activity. Life purpose mediated the prospective relationship between reengagement capacity and multiple aspects of well‐being. The relationships between purpose and positive/negative affect were reciprocal over time. Results also suggested that physical activity is not a mediator, but is in fact a result of the effect of reengagement capacity on well‐being. The results demonstrate that reengagement capacity is important for well‐being among women with breast cancer.     

Health performance of individuals within the Campbell paradigm

In this paper, we developed a comprehensive health performance measure that formally links individual health attitudes with the likelihood of engaging in a wide variety of health‐related behaviours from various domains such as sustenance, hygiene, and physical exercise. Within what Kaiser, Byrka, and Hartig (2010) call the Campbell paradigm, we equated general health attitude with what a person does to retain or promote his or her health. Thus, health behaviours, on one hand, were expected to form a homogeneous, transitively ordered class of behaviours. On the other hand, the very behavioural class was in turn thought to be the basis from which an individual's health attitude could be directly assessed. A sample of 391 adults provided us with survey data containing different sets of health behaviours as well as variables and personality measures that had been corroborated as health‐behaviour relevant in previous research. We found that self‐reports of 50 behaviours and expressions of appreciation for 20 of these behaviours from various domains formed a transitively ordered class of activities. In contrast to the conventional view in health psychology, in which attitudes are regarded as a psychological cause behind individual behaviour, and in contrast to conventional findings in health psychology, where behaviours appear to fall into numerous sets of more or less distinct domains of health‐enhancing activities (e.g., exercising or avoiding risks), our findings speak of the psychological and formal unity of health behaviour. Inevitably, attitude measures grounded in the Campbell paradigm gauge individual attitudes, and just as much, they measure the health performance of individuals.     

Predicting Potentially Harmful Psychological and Physical Behaviours by Parental Caregivers toward Children with Autism Spectrum Disorder

Mistreatment of dementia patients by spousal care providers is fairly common. Caregivers’ characteristics, particularly their psychosocial, physical and cognitive functioning, and coping behaviours, predict reports of elder mistreatment. Parental caregivers of children with autism spectrum disorder (ASD) however, despite the similarities they share with dementia caregivers, have not been studied in this context. A sample of N?=?95 caregivers of children with ASD completed an online survey assessing: (a) psychosocial, physical and cognitive functioning, and (b) coping behaviours. Caregivers also: (c) rated the extent to which they used potentially harmful psychological (e.g., screamed at the child) and physical (e.g., slapped the child) behaviours to cope with caregiving challenges over the last 12 months. Rates of potentially harmful psychological and physical behaviours were extremely low. However, 95% of caregivers reported using at least one potentially harmful psychological behaviour at some point in the last 12 months, and almost 38% reported using at least one potentially harmful physical behaviour. Mediation analysis yielded an indirect effect of psychological distress on potentially harmful psychological behaviours through disengaged coping. In conclusion, rates of potentially harmful behaviours appear to be low in the context of caring for a child with ASD. Caregivers reporting increased psychological distress were more likely to use potentially harmful psychological behaviours, and this effect was partially mediated by greater use of disengaged coping.     

Are exercise social-cognitive factors and behaviours different for adults with diabetes? A randomized community sample

Exercise plays a key role in the prevention and delay of the onset of Type 2 diabetes and in the management of this disorder. To determine if there are differences in key social-cognitive determinants of exercise and self-reported physical activity levels between adults with diabetes and those without the condition, a random selected sample of adults was surveyed. A telephone interview assessed physical activity behaviour and key social-cognitive constructs from major health behaviour change theories/models. The mean energy expenditure was not significantly different between the diabetes (n?=?46) and the non-diabetes (n?=?1556) groups. The diabetes group reported significantly lower scores for self-efficacy and perceived behavioural control, but higher for fear of, and vulnerability to, general health and cardiovascular disease threat. The data suggest that it may not be necessary to promote health threat messages, as threat is already high for this diabetes population and studies have shown that excess threat does not promote recommended exercise and health behaviours. Instead, the low levels of self-efficacy and perceived behavioural control among those with diabetes emphasize the importance of designing specific strategies (e.g., skills, incremental success) to increase their self-confidence in undertaking physical activity.     

The effects of exercise withdrawal on mood and inflammatory cytokine responses in humans

Mechanisms underlying the relationship between exercise and mood are not well understood. This study sought to investigate the role of pro- and anti-inflammatory cytokines and autonomic balance in determining the impact of exercise withdrawal on negative mood. Healthy men and women who regularly exercised (N?=?26, mean age?=?25.5 years, SD?=?4.5 years) were randomised to exercise withdrawal or exercise maintenance for 2 weeks. Protocol adherence was monitored using accelerometers. Inflammatory markers from plasma (interleukin-6, IL-6; tumour necrosis factor-alpha; interleukin-10; and interleukin-1 receptor antagonist), heart-rate variability (HRV) and measures of mood (General Health Questionnaire-28 (GHQ) and the Profile of Mood States (POMS)) were assessed at study entry and at 2-week follow-up. Exercise withdrawal resulted in significant increases in negative mood over time on both the GHQ (p?=?0.028) and the POMS (p?=?0.005). Following the intervention, IL-6 concentration was lower in the exercise withdrawal than exercise maintenance condition (p?=?0.05). No intervention effects were observed for other cytokines or HRV. The mood changes were significantly related to changes in IL-6 concentration (β?=?-?0.50, p?=?0.011), indicating that reduction in IL-6 was related to increased negative mood. Our results are consistent with positive effects of exercise on mental health, but further research on inflammatory pathways is warranted.     

Sexual Minority Stress and Social Support Explain the Association between Sexual Identity with Physical and Mental Health Problems among Young Lesbian and Bisexual Women

Bisexual women report more physical and psychological health problems than lesbian women do, which may be attributed to greater sexual minority stress and less social support. However, many studies combine lesbian and bisexual women into a single group. The current study examined if sexual minority stress and social support mediated the association between women’s sexual identity (lesbian or bisexual) and health-related outcomes. A total of 650 U.S. young adult lesbian (n?=?227) and bisexual (n?=?423) women completed an online survey about sexual minority stress, social support, and physical and mental health problems. Bisexual women reported more physical and mental health problems. A sequential mediation model showed that bisexual women reported greater sexual minority stress than lesbian women, which in turn was associated with less social support, which was associated with more physical and mental health problems. Greater sexual minority stress and lower social support may help explain why bisexual women report more health-related problems than lesbian women. The results of the present study support the importance of examining risk and protective factors for health problems separately for lesbian and bisexual women. Health-related intervention programs that target sexual minority women may need to be tailored differently for lesbian and bisexual women.