Psychological and behavioural effects of bone density screening for osteoporosis

Abstract

To examine the psychological effects of bone density measurement, 298 women were assessed two weeks before the bone density scan, immediately before the scan, after the results, a week later and three months later. For the group as a whole, ratings of anxiety and perceived vulnerability were lower at the three month follow-up than at the initial assessment. Women who received a low bone mineral density (BMD) result were more anxious and reported more osteoporosis-preventive behaviours at the three month follow-up than women who received a high BMD result; these differences had not been apparent at the initial assessment Women with low BMD results had higher ratings of perceived vulnerability after the scan, although for some of these ratings there were group differences before the scan. Women with a low BMD result showed a decrease in ratings of the seriousness of a below-average result, which may reflect minimization of the health threat     

Reactions to Medical Diagnosis: The Role of Illness Stereotypes

Two studies were conducted to explore the role of illness stereotypes in appraisals of health threat. The results of Study 1 indicated that a substantial proportion of questionnaire respondents believed that high blood pressure (BP) is associated with positive personal characteristics (e.g., persistence) whereas a smaller proportion believed that high BP is associated with negative characteristics. In addition, more favorable stereotypes were correlated with lower ratings of the seriousness of high BP. Study 2 examined the effects of experimentally induced illness stereotypes on the health-related judgments of subjects who received false feedback on a test of their BP. The results revealed a significant effect of illness stereotypes on health-threat appraisals of high BP. Subjects who were led to believe that high BP was associated with achievement and competence perceived high BP as a less serious threat to health than did subjects who believed high BP was associated with less desirable traits. In addition, subjects given high BP readings reported fewer symptoms they were told were associated with high BP when the disorder was associated with negative characteristics. The results demonstrate the importance of illness stereotypes in appraisals of health threats, symptom reporting, and reactions to medical diagnosis.     

Communicating Information About Medication: The Benefits of Making it Personal

Two experiments, using a controlled empirical methodology, investigated the effects of presenting information about medicines using a more personalised style of expression. In both studies, members of the general public were given a hypothetical scenario about visiting the doctor, being diagnosed with a particular illness, and being prescribed a medication. They were also given a written explanation about the medicine and were asked to provide ratings on a number of measures, including satisfaction, perceived risk to health, and intention to comply. In Experiment 1 the explanation focused only on possible side effects of the medicine, whereas in Experiment 2 a fuller explanation was provided, which included information about the illness, prescribed drug, its dosage and contraindications as well as its side effects. In both studies, use of a more personalised style resulted in significantly higher ratings of satisfaction and significantly lower ratings of likelihood of side effects occurring and of perceived risk to health. In Experiment 2 it also led to significantly improved recall for the written information.     

Definitions of physical abuse: A preliminary inquiry into children's perceptions

Research and policy-makers have frequently called for operational definitions of child abuse, however neither group has considered including children's perceptions of what constitutes abuse. The purpose of this study was to expand the discussion on definitions of child abuse by examining children's perceptions of physical abuse. This was done by collecting data to begin to document abused children's ratings of the seriousness of various abusive acts and to begin to examine gender and age differences in children's perceptions. The data revealed significant differences in children's perceptions of the seriousness of specific acts of abuse and a significant interaction between age and type of abuse. Although young children generally produced lower seriousness ratings than older children, their ratings were significantly lower on only a few types of abuse. When children's ratings were compared to similar ratings reported in earlier studies of adolescents, community members, and mental health professionals, the children in this study rated the abusive acts as less serious than the adolescents or community members, but very similar to the professionals who work in the area of child abuse and neglect. Although this must be considered a preliminary investigation, the potential implications for various legal and social contexts are discussed.     

Judging health status: effects of perceived prevalence and personal relevance

In this article, we show that people's evaluations of the seriousness of a health disorder are influenced by the perceived prevalence and personal relevance of that disorder. As part of a study ostensibly concerned with college students' health characteristics, 60 undergraduates were "tested" for the presence of a fictitious enzyme deficiency. The subjects discovered either that they had the deficiency (deficiency-present subjects) or that they did not have it (deficiency-absent subjects), and were led to believe either that 1 of the 5 people in the laboratory had the deficiency (low-prevalence subjects) or that 4 of them had it (high-prevalence subjects). As predicted, the low-prevalence subjects evaluated the deficiency as more serious than did the high-prevalence subjects. In addition, consistent with the view that personal relevance affects perceptions of health disorders, the deficiency-present subjects evaluated the deficiency as less serious than did the deficiency-absent subjects. The deficiency-present subjects also derogated the validity of the test ostensibly used to diagnose the deficiency compared with other subjects. Finally, the deficiency-present subjects requested more information about the deficiency than did the deficiency-absent subjects.     

Rarely Occurring Headaches and Rarely Occurring Blindness: Is Rarely=Rarely? The Meaning of Verbal Frequentistic Labels in Specific Medical Contexts

In three experimental studies, factors were examined which might influence the interpretation of verbal frequentistic labels in a specific context (i.e. side effects of medical drugs). In Study 1, we directly assessed subjects' numerical equivalents of three verbal labels (recommended for use by the German Federal Health Agency), which were embedded in stylized leaflets for medical drugs; we compared the estimates with those obtained in a context-free situation. The major findings were that (1) subjects' numerical equivalents for the verbal labels were clearly lower in the context condition than in the context-free situation, (2) subjects'; interpretations appeared to depend on the seriousness of the side effects, but (3) this dependency disappeared when explicit base rates were provided. In Studies 2 and 3, we indirectly examined the influence of the seriousness of the side effects, their frequency, and of the mode of expression (verbally versus numerically) by asking for risk judgments for and choices between drugs. Results of particular importance were that (1) seriousness and frequency of side effects had the same influence on judgments and choices but the mode of expression had no significant effect on either judgments or choices; (2) when subjects’ individual numerical equivalents of verbal labels were used in the leaflets, numerically described drugs were judged equally risky as verbally described drugs but were significantly preferred for consumption. These findings have theoretical relevance for research on the processing of verbal and numerical frequentistic expressions as well as a number of practical implications for the communication of medical information.     

An adolescent symptom checklist for juvenile deliquents

A rating instrument was developed to assess the personality functioning of problem adolescents who have a brief history of official delinquency. Subjects were 186 residents at a short-term diagnostic detention facility. The instrument that emerged from a factor analysis was tested for reliability, validity, and cross-situational generality. Two major orthogonal factors emerged, Apathy-Withdrawal (I) and Anger-Defiance (II). Each factor was found to be congruent with the corresponding dimension on behavior rating instruments that had previously yielded two orthogonal factors and that had been shown to be relevant to a large number of psychological and educational issues. Significant correlations between the factors and a series of global ratings measuring behavior and measures indicative of the frequency and seriousness of official delinquency provided further evidence of construct and discriminant validity as well as evidence of cross-setting consistency of personality functioning.     

Teachers' perceptions of the frequency and seriousness of violations of ethical standards

Despite nationwide efforts to professionalize public-school teaching, little attention has been given to the matter of standards of professional conduct for teachers. The authors examined teachers' perceptions of the frequency and seriousness of different categories of teacher misconduct. They administered a 34-item questionnaire to 235 school professionals in northwestern South Carolina. For each item, respondents rated the extent to which they agreed or disagreed that the behavior occurred frequently and represented a serious violation of professional ethics. Factor analysis of the ratings of seriousness yielded 3 domains of ethical concerns: (a) student-teacher boundary violations, (b) carelessness in behavior, and (c) subjectivity in grading and instruction. Teachers rated boundary violations as the most serious but least common violations and carelessness in behavior as the most frequent but least serious violation. Problems of subjectivity in grading were rated as moderately frequent and moderately serious. The authors found no differences between male and female teachers or between elementary and secondary teachers in their ratings of the seriousness or frequency of any of the 3 groups of ethical concerns. The authors discuss implications for development of a national code of teacher conduct.     

Does the Optimism Bias Affect Help-Seeking Intentions for Depressive Symptoms in Young People?

Help-seeking is an adaptive means to address mental health difficulties, but sufferers often fail to seek assistance. This inaction may reflect optimism bias—that is, believing one is less susceptible to negative events than others. In the present study, the authors investigate optimism bias by presenting depressive symptoms in vignette form to 263 undergraduate participants. Participants were asked to imagine oneself or a peer-group friend suffering from presented symptoms and provide ratings of problem seriousness, help-seeking importance, and prognosis. Results supported the optimism bias hypothesis in that participants reported lower levels of seriousness, lower need for help, and anticipated a more favorable prognosis for themselves compared to others on equivalent sets of symptoms. A contextual effect may exist and influence the evaluation of medium-severity symptoms when symptoms were presented from most to least severe. As symptom severity increased, females were less optimistic than males about prognosis and placed greater importance on help-seeking. The implications of these findings are discussed.     

Development: Compared to what?: Contrast effects in age-comparative paradigms

Recent controversies about judgment competence of preschool and adolescent children are considered as being a possible product of contrast effects. That is, perceived abilities of children of a given age group may depend on the ages of the other subjects in the experiment. An experiment was done to test the possibility of contrast effects in age-comparative experiments. One group of subjects read about three experimental tasks in which 6-year-old children performed better than 4-year-olds. A second group read about 6-year-olds performing worse than 8-year-olds on the same tasks. Performance levels of 6-year-olds were the same on the two forms. For each task subjects rated the competence of each of the two age groups on the task and predicted the performance of the two groups on a related task. Undergraduate subjects' competence ratings and predictions were higher for 6-year-olds when compared to 4-year-olds than when compared to 8-year-olds. Psychology graduate students showed the same contrast effect for predictions but not for competence ratings. The results are discussed in terms of potential biases in age-comparative methods in developmental psychology.     

L’observance et certains de ses déterminants dans les maladies inflammatoires chroniques de l’intestin (MICI)

Factors that favor compliance are not constant in researches about IBD patients. The objective of this study is to determine, in a 79 compliant subjects sample, the links between factors themselves which influence observance: depression, alexithymia, causal attributions, health subjective quality of life, the relation with the physician, the health state evaluation and the rapport between therapeutic benefit/side effects (CGI). Results show that patients comprehend independently factors that motivate them to have treatment and seriousness of their health state. If the relationship established with the physician is perceived as fundamental, personal controllability does not seem essential in compliance. So, it seems important to consider more specifically the link between patient's perceived control and physician's perceived control of the disease.