Program adherence and coping strategies as predictors of success in a smoking treatment program

Ninety-four participants in a 6-week behaviorally oriented smoking cessation program were administered weekly questionnaires assessing their use of the major program recommendations and other quitting strategies throughout treatment. An "affect-regulation" coping inventory was administered at the beginning and end of treatment as well. Adequate adherence was reported for most of the program recommendations. Although a composite measure of adherence did not predict quitting success, adherence and coping assessments were associated with maintenance of treatment gains. Short-term maintenance was associated with an extensive affect-regulation repertoire and use of "stimulus control" strategies during the program, and long-term maintenance was associated with consistent self-monitoring of smoking during treatment. These prospective findings highlight some behavioral characteristics that may be useful targets in future efforts to foster maintenance of smoking behavior change.     

Self-efficacy and social support as predictors of smoking after a quit attempt

Abstract

The current study examined self-efficacy and social support as predictors of maintenance after an attempt to stop smoking. As in previous studies, self-efficacy at the end of treatment was a significant predictor of reported smoking during the follow-up period. At 3 months after treatment the prediction from self-efficacy was weaker than a prediction from the level of post-treatment smoking. However at 10 months self-efficacy was the strongest predictive variable assessed in the study. In contrast, social support for the quit attempt was not a significant predictor of maintenance at any stage. The results provided qualified support for the contention that self-efficacy can often be a more powerful predictor than previous performance attainments, especially under conditions of greater situational change.     

Expectancy-value constructs and expectancy violation as predictors of exercise adherence in previously sedentary women.

This prospective study examined effects of expectancy of exercise benefits, value of benefits, expectancy violation, and self-efficacy (SE) on exercise behavior and study dropout in sedentary women (n=86). SE predicted exercise for study completers but did not predict study dropout. After 6 and 12 weeks, participants evidenced expectancy violations, particularly for fitness and weight. Initial value, expectancy, and Expectancy X Value did not predict exercise for study completers, but dropouts had higher initial positive expectancies than did completers. Expectancy violations produced in Weeks 1-6 did not predict exercise in Weeks 7-12 in study completers, but dropouts in Weeks 7-12 had higher expectancy violations for weight in Weeks 1-6 than did completers. Follow-up revealed that study dropouts stopped exercising. Identifying individuals with high initial expectancies and expectancy violations may improve health behavior intervention and research.     

Optimism and neuroticism as predictors of coping and adaptation in older women

This prospective correlational study looked at the relationship between optimism, perception of stress, coping, and adaptation in women over the age of 60. One hundred and nine women took part in two interviews, separated by a minimum interval of 3 months. Although optimism was found to be correlated with most of the dependent variables (DVs), hierarchical regression analyses revealed that it lost its predictive power when the effects of the covariates, particularly Time 1 measures of the DVs and neuroticism, were statistically removed. The most important predictors of coping, distress, and life satisfaction were initial measures of these variables, followed by neuroticism. The discussion of the findings focuses on the need to clarify the construct of optimism. It supports the idea that optimism may be better conceptualized as a two-dimensional construct (optimism/pessimism), subsumable under two of the ‘Big Five’ personality factors, namely Extraversion and Neuroticism, respectively.     

An examination of sex differences in social support among older men and women

This paper is designed to empirically investigate sex differences in social support. Several types of sex differences are examined, including quantity and quality of support, the relationship between quantitative and qualitative measures of support, the number and source of support provided and received, and the relative predictive power of quality and quantity of support on well-being. The data are taken from the Supports of the Elderly, a national survey of older people (Kahn and Antonucci, 1984). Included in the present study are 214 men and 166 women ranging in age from 50 to 95 who are married and have at least one child. The analyses reveal that women have larger networks and receive supports from multiple sources, while men tend to rely on their spouses exclusively. Men report greater satisfaction with marriage than women. Quantitative supports are more related to qualitative supports for women than for men. For both sexes, the quality of support rather than the quantity of support has significantly greater effects on well-being; both the quantity and quality of social support have a greater impact on the well-being of women compared to men.     

A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy.

Nonadherence in the management of chronic illness is a pervasive clinical challenge. Although researchers have identified multiple correlates of adherence, the field remains relatively atheoretical. The authors propose a cognitive-affective model of medication adherence based on social support theory and research. Structural equation modeling of longitudinal survey data from 136 mainly African American and Puerto Rican men and women with HIV/AIDS provided preliminary support for a modified model. Specifically, baseline data indicated social support was associated with less negative affect and greater spirituality, which, in turn, were associated with self-efficacy to adhere. Self-efficacy to adhere at baseline predicted self-reported adherence at 3 months, which predicted chart-extracted viral load at 6 months. The findings have relevance for theory building, intervention development, and clinical practice.     

Social control,social support,and companionship in older adults' family relationships and friendships

Social control, social support, and companionship represent basic elements of many close relationships, yet we know relatively little about how these distinctive elements separately and jointly influence relationship quality. Control and support may have incompatible effects, with efforts by a family member or friend to influence a focal person's behavior undermining the sense of support in the relationship. We examined the implications of control, support, and companionship for the perceived quality of older adults’family relationships and friendships in a sample of 180 older adults. Analyses indicated that the participants’family members and friends were differentially involved in performing control, support, and companionship functions. In addition, perceived relationship quality appeared to be anchored in somewhat different functions for family members versus friends. The perceived quality of family ties was related to emotional support, companionship, and social control, whereas the perceived quality of ties with friends was related to emotional support, instrumental support, and companionship. Contrary to expectation, we found no evidence that social control detracted from perceived relationship quality or that social control interacted with social support in predicting relationship quality. The results help to extend existing knowledge of relationship specialization in later adulthood, and they underscore the usefulness of distinguishing social control, social support, and companionship.     

Efficacy and social support as predictors of parenting stress among families in poverty

Using a sample of low‐income mothers enrolled in Early Head Start (n = 65), this study tested the hypothesis that parenting stress is affected by social support and self‐efficacy, in addition to family risk status and family income. Specifically, it was proposed that social support and self‐efficacy are psychological resources that are associated with lower parenting stress levels, and would moderate the impact of family income on parenting stress. A significant proportion of variance in parenting stress was explained by self‐efficacy, family risk, and the interaction of self‐efficacy and family income; family income alone was not a significant predictor of parenting stress levels. Mothers higher in self‐efficacy had lower levels of parenting stress, and income was less associated with parenting stress levels for mothers high in self‐efficacy. Social support was not associated with lower parenting stress levels, nor did social support moderate the effect of income on parenting stress. Family risk was also a strong and reliable predictor of parenting stress, suggesting that family circumstances are perhaps better predictors of parenting stress levels than income alone. These findings suggest that parenting stress among low‐income parents should be viewed as a function of psychological, as well as financial, resources.     

Perceived self-efficacy domains as predictors of fear of the unknown and fear of dying among older adults

Using a sample of 167 women and 121 men, aged 65-87, this study tested the hypothesis that self-efficacy beliefs of older persons are significantly stronger predictors of death fears than are demographics, social support, and physical health variables used in earlier predictor models. Standard self-report measures were used to assess all predictor variables, including perceived self-efficacy in 8 different domains. Findings from a series of hierarchical regression analyses that were conducted separately for men and women supported the hypothesis concerning the superiority of self-efficacy variables as predictors of fear of the unknown after death and fear of dying, with spiritual health efficacy and instrumental efficacy being the most potent predictors of death fears for women and men, respectively.     

Activity experiences shape perceived fitness trajectories: Results from a 6-month randomized controlled trial in older women

ABSTRACT

In this study we addressed the subjective benefits of activity interventions that were designed to improve cognitive fitness in old age. Two hundred and fifty-nine women (aged 70–93 years) were randomized to participate in an exercise or a computer course or a control condition for 6 months. Subjective ratings of the perceived change of cognitive and physical fitness components were captured before, during, after the intervention interval, and at a 10-month follow-up. Positive and negative affect levels and objective cognitive fitness parameters served as possible covariates. Multilevel modeling revealed that the computer group rated memory and concentration as having improved at 4 months and again at 6 months. The exercise group, in contrast, perceived physical capacities as maintained or improved. The characteristics of the activity experience seem to determine the perceived fitness changes. We conclude that actual learning experiences improve one's self-concept of abilities.     

Age-associated predictors of medication adherence in HIV-positive adults: health beliefs, self-efficacy, and neurocognitive status.

OBJECTIVE: Although most agree that poor adherence to antiretrovirals is a common problem, relatively few factors have been shown to consistently predict treatment failure. In this study, a theoretical framework encompassing demographic characteristics, health beliefs/attitudes, treatment self-efficacy, and neurocognitive status was examined in relationship to highly active antiretroviral therapy adherence. DESIGN: Prospective, cross-sectional observational design. MAIN OUTCOME MEASURES: Neuropsychological test performance, health beliefs and attitudes, and medication adherence tracked over a 1-month period using electronic monitoring technology (Medication Event Monitoring System caps). RESULTS: The rate of poor adherence was twice as high among younger participants than with older participants (68% and 33%, respectively). Results of binary logistic regression revealed that low self-efficacy and lack of perceived treatment utility predicted poor adherence among younger individuals, whereas decreased levels of neurocognitive functioning remained the sole predictor of poor adherence among older participants. CONCLUSION: These data support components of the health beliefs model in predicting medication adherence among younger HIV-positive individuals. However, risk of adherence failure in those ages 50 years and older appears most related to neurocognitive status.     

Activity experiences shape perceived fitness trajectories: results from a 6-month randomized controlled trial in older women

In this study we addressed the subjective benefits of activity interventions that were designed to improve cognitive fitness in old age. Two hundred and fifty-nine women (aged 70-93 years) were randomized to participate in an exercise or a computer course or a control condition for 6 months. Subjective ratings of the perceived change of cognitive and physical fitness components were captured before, during, after the intervention interval, and at a 10-month follow-up. Positive and negative affect levels and objective cognitive fitness parameters served as possible covariates. Multilevel modeling revealed that the computer group rated memory and concentration as having improved at 4 months and again at 6 months. The exercise group, in contrast, perceived physical capacities as maintained or improved. The characteristics of the activity experience seem to determine the perceived fitness changes. We conclude that actual learning experiences improve one's self-concept of abilities.     

Differential social support and life change as contributors to the social class-distress relationship in older adults

Four hypotheses previously put forth to explain the strong association between social class and mental health in the general population were examined in 1,326 older adults (55 years and older). Respondents were interviewed 3 times at 6-month intervals. Lower class was associated with more past life changes (occurring before Wave 1) and more subsequent life events (occurring between Waves 1 and 3); these changes were predictive of distress, supporting the differential exposure hypothesis. Lower class was associated with weaker social support (embeddedness), which was related to distress, supporting the resource deterrent hypothesis. There was little evidence that people of the lower classes were more vulnerable to stress or that their status was due to their weaker social support; thus, the differential vulnerability and applied buffering hypotheses were not consistently supported. Social support does appear to be a versatile resource for older adults. A significant portion of the class-distress relationship was not accounted for by life change, social support, or the interaction between these factors.     

Internet use and social support in women with breast cancer.

Many Web sites offer information to breast cancer patients, who are increasingly using these sites. The authors investigated the potential psychological benefits of Internet use for medical information by breast cancer patients. Of the 251 women approached, 188 were successfully interviewed (74.9%). Forty-two percent used the Internet for medical information related to breast health issues and did so for an average of 0.80 hr per week. The Interpersonal Support Evaluation List and the UCLA Loneliness Scale, with results controlled for covariates, showed that Internet use for breast health issues was associated with greater social support and less loneliness than Internet use for other purposes or nonuse. Breast cancer patients may obtain these psychological benefits with only a minimal weekly time commitment.     

International students' reported English fluency,social support satisfaction,and social connectedness as predictors of acculturative stress

This study explored age, gender, reported English fluency, social support satisfaction and social connectedness as predictors of acculturative stress among a sample of 359 international students. Results indicate that international students from Europe experienced less acculturative stress than their counterparts from Asia, Central/Latin America, and Africa. Moreover, English fluency, social support satisfaction, and social connectedness were all predictors of acculturative stress. Implications for counselling and research are discussed.     

Peer relationships as a source of support for adolescent mothers

There is speculation that the pregnancy and parenthood of adolescent mothers cause changes in their peer relationships such that their peers become less able to provide support. Little empirical evidence exists to support such speculation. The authors assessed the relative amounts and types of support provided by friends and relatives to adolescent mothers, and examined peer support in relation to parenting stress. Invitations were sent to all 480 women recruited through public access birth records in two northeastern Ohio counties who were 19 years old and younger and who had given birth to their first child during the previous nine months. The counties incorporate urban, suburban, and rural communities. 66 women volunteered, of whom 46 eventually participated in the study. They were aged 13-19 years (mean age, 17.43 years) at the birth of their child. Approximately 66% were White and 12 were married. Of the 36 women who reported their family income, 88% reported yearly income of less than $20,000; of those, 15 reported income of less than $5000. 28 of the adolescent mothers were unemployed. 22 were enrolled in school at the time of data collection. Of the 24 who were not enrolled in school, 15 had already completed 12th grade. The Inventory of Social Contacts measured levels of perceived child-rearing, emotional, and material support and interference from family and friends, while the Parenting Stress Index assessed self-reported parenting stress arising from child and parent characteristics. Results of repeated-measures ANOVAs and Pearson correlations indicate that, compared to family, friends provide more emotional support and less interference. Parenting stress is buffered more effectively by the support provided by friends.     

Developing a scale of self-efficacy in personal relationships for adolescents

This study developed a scale of self-efficacy in personal relationships for adolescents and examined its reliability and the validity. The 40 items assessing tendencies theoretically linked to self-efficacy in personal relationships were administered to 344 junior and high school students. 207 high school students also were administered the Shimoda Personality Inventory. Three factors (Self-confidence in Personal Relationship, Trust in Friends, and Trust by Friends) were extracted by principal components analysis. The coefficient alpha reliabilities of these subscales were .90, .89. and .87. The validity was supported by correlations between the Total score of self-efficacy and the SPI subscales of Autistic trait -.53, Nervous Character trait -.13, Self-uncertain trait -.39, and Syntonic trait .57.     

Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis

Pain-related avoidance factors and social resources, as assessed by pain coping and social support, are supposed to have lasting effects on functional disability and pain in chronic pain disorders. As a follow-up to a prospective study demonstrating short-term effects after one year (Behaviour Research and Therapy, 36, 179-193, 1998), the role of pain coping and social support at the time of diagnosis was investigated in relationship to the long-term course of functional disability and pain after three and five years in 78 patients with rheumatoid arthritis (RA), taking into account personality characteristics of neuroticism and extraversion, clinical status and use of medication. In line with findings at the one-year follow-up, results showed that more passive pain coping predicted functional disability at the three-year, but not the five-year follow-up. In addition, low levels of social support at the time of diagnosis consistently predicted both functional disability and pain at the three and five-year follow-ups. Results indicate that pain coping and social support, assessed very early in the disease process, can affect long-term functional disability and pain in RA, and suggest that early interventions focusing on pain-related avoidance factors and social resources for patients at risk may beneficially influence long-term outcomes in RA.     

Exposure to community violence and social support as predictors of anxiety and social and emotional behavior among African American children

We examined the effects of exposure to violence and social support on self-reported state and trait anxiety and parental rated problem behaviors among school-aged African-American children in low and high violence areas. Ninety-seven (97) fourth through sixth graders and their parents were interviewed about exposure to community violence, social support, and state and trait anxiety. Results indicate that trait anxiety was correlated positively with exposure to violence and negatively with social support. State anxiety was correlated negatively with family social support. Problem behaviors were correlated negatively with family support and income. Hierarchial multiple regression analyses indicated that children's reports of their exposure to community violence continued to explain significant variability in trait anxiety, and problem behavior after controlling for both income and social support measures. Social support from peers, family and teachers played differential roles in predicting problem behaviors among children from high and lower violence areas. These findings suggest that in planning intervention programs for children exposed to violence, greater attention to empowering parents to support their children, to fostering peer group support, and to bolstering teacher support may be useful, but attention to the underlying socio-political causes of violence exposure is essential.     

Temporal information processing and pitch discrimination as predictors of general intelligence.

In the present study, the relationship between performance on temporal and pitch discrimination and psychometric intelligence was investigated in a sample of 164 participants by means of an experimental dissociation paradigm. Performance on both temporal and pitch discrimination was substantially related to psychometric intelligence (r=.43 and r =.39). Regression analysis and structural equation modeling suggested that both psychophysical domains can be considered as valid predictors of psychometric intelligence. Both predictor variables contributed substantial portions of both shared and unique variance to the prediction of individual differences in psychometric intelligence. Thus, the present study yielded further evidence for a functional relationship between psychometric intelligence and temporal as well as pitch discrimination acuity. Eventually, findings are consistent with the notion that temporal discrimination - in addition to general aspects of sensory discrimination shared with pitch discrimination reflects specific intelligence-related aspects of neural information processing.