The stages and processes of exercise adoption and maintenance in a worksite sample.

We applied the model of the stages and processes of change to exercise adoption and maintenance. This model has shown promise in advancing theory and treatment of the addictions and other negative health behaviors, but there have been few systematic attempts to apply the model to positive health behaviors, such as exercise adoption. Questionnaires dealing with the stages and processes of exercise change were developed and administered to a sample of 1,172 participants in a worksite health promotion project. The sample was split randomly into halves for (a) initial model development and testing and (b) confirmatory measurement model testing. Additional model confirmation was obtained by examining the hierarchical structure of the processes of change and by conducting Stage x Process analyses. Results suggest that the underlying constructs derived from smoking cessation and other addictive behaviors can be generalized to exercise behavior. Understanding the stages and processes of exercise behavior change may yield important information for enhancing exercise adoption, adherence, and relapse prevention at both individual and public health levels.     

Assessing motivational readiness and decision making for exercise.

Motivational and cognitive processes of behavior change with respect to the area of exercise adoption were investigated. A total of 778 men and women, recruited from four worksites, answered a 40-item questionnaire consisting of statements based on constructs from the trans-theoretical model of behavior change. Principal-components analysis identified two factors--one a 6-item component representing avoidance of exercise (Cons), the other a 10-item component representing positive perceptions of exercise (Pros). Analysis of variance showed that the Pros, Cons, and a Decisional Balance measure (Pros minus Cons) were significantly associated with stage of exercise adoption. Results are consistent with applications of the model to smoking cessation and other areas of behavior change. Distinctions between exercise adoption and behaviors such as smoking cessation, weight loss, and alcoholism are discussed.     

时间洞察力对成瘾行为的影响及其机制

成瘾行为给个体和社会带来了严重的危害。对成瘾人群时间洞察力的研究成为探讨成瘾行为产生和发展的一个新的视角。过去消极、现在享乐和现在宿命时间洞察力取向的个体更可能出现成瘾行为, 而未来时间洞察力取向则是成瘾行为的一个保护性因素, 它不仅可以减少成瘾行为的发生, 也有利于成瘾行为的康复。从自我调节, 冲动性决策等行为机制和前额叶的神经机制方面可以帮助我们深入理解时间洞察力对成瘾行为的影响。未来研究可以进一步探讨不同成瘾行为者时间洞察力的一致性与特异性; 采用纵向研究方法探讨成瘾者时间洞察力的动态变化过程; 对成瘾者的洞察力进行干预, 增加成瘾者的未来时间洞察力, 减少其过去消极和现在时间洞察力取向来帮助成瘾者实现时间洞察力的平衡, 从而提高其戒断效果。     

Existe-t-il une typologie familiale dans les pathologies addictives ? Revue critique de la littérature sur les familles d’adolescents présentant des troubles alimentaires ou des conduites de dépendance aux substances

Among factors favoring the addictive behaviors, some specific family processes are often identified in eating disorders and dependences with psychoactive substances. Different models of systemic orientation described the familial disturbances involved in the addictive pathologies emphasizing either the emotional interaction and the processes of differentiation family, either the structure and the level of family cohesion. This article proposes a critical review of the systemic literature on the familial disturbances involved in the families of adolescents with eating disorders or with a substance-dependence. The systemic models (Bowen, Minuchin) are reference values in the understanding of family processes and therapy with families. The observations of these family processes have been confronted to empirical researches integrating different epistemological levels and different methods. The empirical results are heterogenous concerning the different forms of family functioning associated with these addictive pathologies. The empirical studies support the hypothesis of a family dysfunctioning in the different addictive behaviors and demonstrate the relationship between the severity of familial disorders and the severity of the addictive disorders. However, the family configuration described by the typological models is rarely found complete or with a similar intensity between the families. The studies support the hypothesis of an emotional distance in the family interactions and a lack of parental care which could correspond to factors of chronicity or vulnerability. Comparing the family characteristics of these two types of addictive behaviors, the literature supports the existence of (1) some specific family characteristics according to the type of addictive behavior (in particular the conflict avoidance which appears specifically in anorexic families) (2) some similar family patterns of interactions between the members of addictive families in particular the representation of a low family cohesion, an intergenerational enmeschment and a high level of control. These family patterns suggest rather to a dimensional approach of the family characterized by different protective or risk factors. We suggest that these family patterns could constitute, according to their importance (intensity and frequence), a family risk factor of development or aggravation of the addictive behaviors.     

冲动性对不同成瘾行为发展的调控及其神经机制

近年来越来越多的研究证据提示, 个体冲动性在成瘾疾患发生发展机制中具有关键作用, 可能成为成瘾行为的潜在易感标记以及早期识别和干预的重要靶点, 但冲动性对不同成瘾行为变化发展的调控机制尚不明确。项目拟综合跨成瘾谱系比较、纵向追踪设计、冲动行为干预等研究途径, 采用人格测量、神经认知、神经影像等技术, 首先比较尼古丁依赖者与网络游戏成瘾者的冲动性结构及其在前额叶–纹状体环路的结构功能改变; 然后采用混合分组设计筛选出具有高低冲动性的非成瘾青少年进行连续追踪研究, 考察冲动性对尼古丁依赖与网络游戏成瘾的预测效力; 并采用认知行为训练, 对吸烟成瘾者与网络游戏成瘾者进行冲动干预, 考察行为干预对冲动性水平及前额叶–纹状体环路功能的改变, 以及对不同成瘾行为发展的抑制后效。旨在探索冲动性作为成瘾的潜在易感标记及干预靶点的效力。     

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.     

Am I the Only One This Supervisor is Laughing at? Effects of Aggressive Humor on Employee Strain and Addictive Behaviors

Prior literature on humor primarily documents its positive effects on employees’ attitudes and behaviors, though increasing research on aggressive humor suggests some conflicting viewpoints. This paper proposes a model based on social comparison and attribution theories to examine the influence of supervisors’ aggressive humor on employees’ strain and addictive behaviors. The tests of the research model entailed a 2‐wave study with 243 frontline employees from 4 manufacturing companies of a group corporation in China. The results showed that supervisors’ aggressive humor with employees related positively to employees’ strain. This positive association became stronger when the supervisors did not use aggressive humor with the peers of the focal employees. Employees’ strain mediated the interactive effects of supervisors’ aggressive humor with the focal employees and those with their peers on employees’ addictive behaviors (e.g., problematic use of Internet, alcohol, and tobacco). As well as having practical implications, this study offers theoretical insights for research into humor, leadership, and addictive behaviors.     

Élaboration du Questionnaire de mesure de l’intensité des conduites addictives (QMICA) : évaluation des addictions et co-addictions avec et sans substances

Referring to studies about addictive behaviors, the objective of this article is to present the validation of a new tool for the assessment of the addictive behaviors with or without substances: the Addictive Intensity Evaluation Questionnaire (AIEQ). Twelve different versions of the AIEQ have been administered to 354 participants in order to assess their addictive behaviors. The study of the factorial structure of the questionnaire and its reliability allow us considering the psychometric qualities of the AIEQ as satisfactory. The results suggest the existence of a continuum between the absence of addiction and the severe forms of addiction. The discussion section proposes a classification based on the severity of the addictive behaviors and applications of the use of the AIEQ.     

Stages of change and stuttering: a preliminary view

As a way to better understand the process of change that occurs in stuttering, Craig [Craig, A. (1998). Relapse following treatment for stuttering: a critical review and correlative data. Journal of Fluency Disorders, 23, 1-30] compared the behavioral changes that people who stutter often experience with and without treatment to those that have been observed for certain (non)addictive behavior disorders such as smoking, overeating, phobia and anxiety disorder. The process underlying these behavioral changes has been described by the transtheoretical or "stages of change" model, which is a model of behavior change that can illuminate "where" a person is in the process of change, and how this may relate to the outcome of either treatment or self-change attempts [Prochaska, J. O., & DiClemente, C. C. (1986). The transtheoretical approach. In J. C. Norcross (Ed.), Handbook of eclectic psychotherapy. New York: Brunner/Mazel]. The purpose of the present study was to analyze the extent to which the responses of adults who stutter on a modified Stages of Change Questionnaire yield interrelations among questionnaire items that are consistent with a stage-based interpretation. Results of both confirmatory and exploratory factor analyses indicated that while the modified questionnaire was a relatively good fit for participant responses, the structure derived from the exploratory analysis provided a significantly better fit to the observed data. Results suggest that a questionnaire incorporating items that better reflect the unique behavioral, cognitive and affective variables that characterize stuttering may better discriminate stages of change in people who stutter as they move through therapy, or are engaged in self-directed change. Educational objectives: After reading this paper, the learner will be able to: (1) describe the transtheoretical or "stages of change" model; (2) describe the various processes that are associated with different stages of change; (3) summarize research findings in stages of change as they apply to a variety of clinical populations; (4) discuss the applicability of the findings from the present study to stuttering treatment, and (5) relate conventional strategies and techniques used in stuttering therapy to different stages in the process of change.     

Disagreeable narcissism mediates an effect of BAS on addictive behaviors

Some forms of personality dysfunction that are associated with substance use and other externalizing behaviors, such as Narcissistic Personality Disorder, are characterized by low five-factor Agreeableness. Low Agreeableness and high Extraversion are both associated with the Behavioral Approach System in the revised Reinforcement Sensitivity Theory of Personality (RST; McNaughton & Corr, 2008). Meta-analyses examining personality predictors of Substance Use Disorders (Kotov et al., 2010) and Pathological Gambling (MacLaren et al., 2011) have implicated low Agreeableness but not Extraversion. In the present study, we sampled undergraduate students (N = 346) to examine relationships between two aspects of grandiose narcissism measured by the Narcissistic Personality Inventory (NPI), approach motivation measured by the BIS/BAS scales, and self-reported addictive behaviors. Disagreeable and Extraverted subscales of the NPI were examined for possible mediation of associations between BAS and addictive behaviors. The more disagreeable aspect of narcissism mediated the effects of BAS on drug use, gambling, sex, and maladaptive intimate relationships. These results suggest that one mechanism through which the Behavioral Approach System may promote addictive behavior among grandiose Narcissists is through its association with their aggressive and antagonistic interpersonal style.     

Is the sequencing of change processes by stage consistent across health problems? A meta-analysis.

Clinicians and researchers applying the transtheoretical model (J.O. Prochaska, C.C. DiClemente, & J.C. Norcross, 1992) to health promotion often assume that relationships of processes and stages observed in smoking cessation can be generalized to other problems. A reanalysis of 47 cross-sectional studies determined that use of change processes varies by stage, but the sequencing of processes is not consistent across health problems. In smoking cessation, cognitive processes were used in earlier stages than were behavioral processes. In exercise adoption and diet change, use of behavioral and cognitive processes increased together. Results for substance abuse and psychotherapy were less consistent. Substituting new behaviors, making a commitment, considering consequences, seeking information, controlling cues, and using rewards varied most by stage. Future longitudinal studies should assess these processes as potential mediators of lifestyle change.     

Relapse as a nonlinear dynamic system: application to patients with alcohol use disorders

Understanding the relapse process is one of the most important issues in addictive behaviors research. To date, most studies have taken a linear approach toward predicting relapse based on risk factors. Nonlinear dynamical systems theory can be used to describe processes that are not adequately modeled using a linear approach. In particular, the authors propose that catastrophe theory, a subset of nonlinear dynamical systems theory, can be used to describe the relapse process in addictive behaviors. Two small prospective studies using 6-month follow-ups of patients with alcohol use disorders (inpatient, n = 51; outpatient, n = 43) illustrate how cusp catastrophe theory may be used to predict relapse. Results from these preliminary studies indicate that a cusp catastrophe model has more predictive utility than traditional linear models.     

A Qualitative Study of the Supports Women Find Most Beneficial When Dealing with a Spouse’s Sexually Addictive or Compulsive Behaviors: Insights for Pastoral Counselors and Clergy

There is currently a void in the literature regarding the kinds of support women find most beneficial when dealing with a spouse’s sexually addictive or compulsive behaviors. Addressing this void is particularly relevant for clergy, seeing as they are increasingly sought out as an initial and/or primary support for dealing with this marital issue. Using grounded theory methodology, 22 women from Canada and the USA were interviewed to find out what they found most helpful as they sought support to cope with a spouse’s sexually addictive and compulsive behaviors. Insights for pastoral counselors and clergy were highlighted.     

Using Therapeutic Letters to Navigate Resistance and Ambivalence: Experiential Implications for Group Counseling

Clients in the early stages of changing addictive behaviors are typically not ready to assume active roles in making significant changes. Navigating these challenges with traditional talk therapy can prove ineffective. Experiential group activities help normalize the difficulties associated with making changes and help clinicians bypass client resistance and ambivalence. The application of one such experiential activity, “Writing a Letter to My Substance/Behavior,” is described and a case study is provided.     

The effect of a psycho-educational intervention on weight management in obese military personnel

Obesity is a serious health problem for many population groups, including military personnel. Model-based health education programs have been shown to be effective in reducing weight. This study assessed the efficacy of an educational intervention based on a trans-theoretical model (TTM) targeting weight loss among active duty military. A single group experimental study using a before-after design was conducted in 49 military personnel with obesity. Constructs such as self-efficacy, decisional balance, stages of change, and processes of change as well as anthropometric measures including weight, waist circumference, and body mass index (BMI) were assessed at three times (baseline, 2 months after the intervention, and 4 months later). The intervention consisted of 10 educational sessions developed based on TTM constructs. At baseline, 30 (61%) and 19 (39%) persons were in the pre-action and action stages, respectively. By 2 months after the intervention, only 24 persons (49%) were in pre-action stages and 25 (51%) were in the action stages. Four months later, one (2%) and 43 (88%) were in pre-action and action stages. The mean changes in self-efficacy (25.7 ± 4.1 to 29.3 ± 2.4), decisional balance (9.2 ± 3.6 to 13.8 ± 1.9), total cognitive (74.7 ± 8.5 to 84.7 ± 6.3), and total behavioral change (60.8 ± 9.8 to 71.7 ± 7.8) were significantly different across the three time points. Reductions in weight (99.8 ± 10.4 to 93.0 ± 9.6), waist circumference (105.9 ± 14.2 to 100.2 ± 13.0), and BMI (32.5 ± 5.2 to 30.3 ± 4.5) from baseline to 4 months after the intervention were also significant (p < 0.05). An educational program based on TTM may be effective in reducing weight among obese military staff.     

A Systematic Meta-Review of Impulsivity and Compulsivity in Addictive Behaviors

Neuropsychology Review - It is well established that poor inhibitory control confers both a vulnerability to, and maintenance of, addictive behaviors across the substance and behavioral spectrums....     

Cognition at risk: Gestalt/feature-intensive processing and cigarette smoking in college students

Although previous research has shown the importance of feature-intensive processing of relevant information in the staving off of addictive behaviors, the present study examined the possibility that a more global, gestalt rejection of cigarette smoking may be operating to reduce smoking behavior. The present study addressed this possibility through the use of a decision efficacy rating procedure, in which smoking and nonsmoking respondents were asked to determine whether an individual was justified in smoking in a variety of given situations. Nonsmokers tended to reject smoking under any circumstances, whereas smokers tended to entertain mitigating circumstances more favorably in justifying smoking, especially when smoking could be construed as providing some perceived positive gains in serious situations. Results are discussed in terms of the gestalt/feature-intensive processing theory of cognition, and in terms of the importance of cognitive approaches to the understanding of addictive behaviors.     

Evaluation of a behavioral measure of risk taking: the Balloon Analogue Risk Task (BART)

The present study (N = 86) sought to evaluate a laboratory-based behavioral measure of risk taking (the Balloon Analogue Risk Task; BART) and to test associations between this measure and self-report measures of risk-related constructs as well as self-reported real-world risk behaviors. The BART evidenced sound experimental properties, and riskiness on the BART was correlated with scores on measures of sensation seeking, impulsivity, and deficiencies in behavioral constraint. Also, riskiness on the BART was correlated with the self-reported occurrence of addictive, health, and safety risk behaviors, with the task accounting for variance in these behaviors beyond that accounted for by demographics and self-report measures of risk-related constructs. These results indicate that the BART may be a useful tool in the assessment of risk taking.     

Cognition at risk: Gestalt/feature-intensive processing and cigarette smoking in college students

Although previous research has shown the importance of feature-intensive processing of relevant information in the staving off of addictive behaviors, the present study examined the possibility that a more global, gestalt rejection of cigarette smoking may be operating to reduce smoking behavior. The present study addressed this possibility through the use of a decision efficacy rating procedure, in which smoking and nonsmoking respondents were asked to determine whether an individual was justified in smoking in a variety of given situations. Nonsmokers tended to reject smoking under any circumstances, whereas smokers tended to entertain mitigating circumstances more favorably in justifying smoking, especially when smoking could be construed as providing some perceived positive gains in serious situations. Results are discussed in terms of the gestalt/feature-intensive processing theory of cognition, and in terms of the importance of cognitive approaches to the understanding of addictive behaviors.