From health beliefs to self-regulation: Theoretical advances in the psychology of action control

Abstract

The paper reviews the theoretical concepts included in a range of social cognitive models which have identified psychological antecedents of individual motivation and behaviour. Areas of correspondence are noted and core constructs (derived primarily from the theory of planned behaviour and social cognitive theory) are identified. The role of intention formation, self-efficacy beliefs, attitudes, normative beliefs and self-representations are highlighted and it is argued that these constructs provide a useful framework for modelling the psychological prerequisites of health behaviour. Acknowledging that intentions do not translate into action automatically, recent advances in our understanding of the ways in which prior planning and rehearsal can enhance individual control of action and facilitate the routinisation of behaviour are considered. The importance of engaging in preparatory behaviours for the achievement of many health goals is discussed and the processes by which goals are prioritised, including their links to self-representations, are explored. The implications of social cognitive and self-regulatory theories for the cognitive assessment of individual readiness for action and for intervention design in health-related settings are highlighted.     

Scary warnings and rational precautions: A review of the psychology of fear appeals

Abstract

Research into the effects of fear-arousal on precautionary motivation and action is reviewed. Current models do not adequately distinguish between emotional (i.e., fear arousal) and cognitive (i.e., threat perception) responses to fear appeals and, in general, are not well supported. Evidence suggesting that (i) coping appraisals are more powerful predictors of precautionary action than threat perception and that (ii) fear control processes may interfere with precautionary motivation, recommends cautious and limited use of fear appeals in health promotion. It seems likely that fear arousal is less important in motivating precautionary action than perceptions of action effectiveness and self-efficacy. Moreover, perceived personal relevance may be critical to the emotional and cognitive impact of threat information. Available findings are summarised in the form of a process model that highlights the potential complexity of fear arousal effects. Sequential measurement of fear arousal, other than by self-report, is recommended in studies seeking to clarify these effects.     

Creative Thinking in Adolescents with Attention Deficit Hyperactivity Disorder (ADHD)

A widened attentional focus, that is typically associated with ADHD, has been postulated to be accompanied by enhanced creative ability. However, creativity has been only limitedly examined in ADHD. Performance across several creativity measures were investigated in three groups: adolescents with ADHD, those with conduct disorder, and a healthy control sample. The ADHD group exhibited selective cognitive advantages and disadvantages by demonstrating an enhanced ability in overcoming the constraining influence of examples, but a reduced capacity to generate a functional invention during an imagery task. These findings are interpreted with reference to inhibitory control mechanisms and the contextual modulation of creative cognition.     

Cognitions associated with initial medical consultations concerning recurrent breathing difficulties: A community-based study

Abstract

A two-stage community survey identified 568 respondents reporting recurrent breathing difficulties over a one-year period. Subsequent interviews allowed comparison of (i) 21 respondents who had never consulted a doctor about frequent wheezing (i.e., on more than 30 days) or serious breathing difficulties (i.e., disrupting everyday activities) over the past year with (ii) a randomly selected group of 22 who had seen their doctor concerning breathing difficulties in the past year. These groups were found to be similar with respect to demographic and lung function measures. An extended health belief model framework including causal attributions for breathing difficulties and consulting self-efficacy was used to explore cognitions which might distinguish between the two groups. Logistic regression suggested that lower perceived relative severity of symptoms (in relation to other problems). attribution of wheezing to smoking and lower self-efficacy in relation to explaining breathing difficulties to a doctor distinguished between those who did and did not consult. Health education implications. including initiatives to encourage medical help-seeking amongst those with recurrent, frequent or serious breathing difficulties are discussed.     

Using Ethnography to Inform Policy and Programs for the Integration of Immigrants: a Case Study in Andalusia,Spain

This paper seeks to extend the utility of ethnography to the planning of successful integration policy and programs for immigrants. I posit that, through a better understanding of the multiple and intersecting contexts in which immigration is located, especially in regard to how culture informs the way that host nationals frame immigration, policy makers and social scientists can work together to formulate policies and programs appropriate to local contexts that are more successful at fostering communities of inclusion and cohesion. Findings from a small ethnographic study completed in Andalusia, Spain, illustrate how experience-near approach, ethnographic research reveals opportunities for co-operation between host nationals and newcomers that can be used by policy makers and others concerned with the welfare of immigrants to foster integration and to promote social cohesion. In doing so, findings from this study demonstrate that culture is not simply a contested site used by members of the dominant group to exclude newcomers, but also a site in which there is the potential for co-operation between members of a community.     

Linking Genetic Counseling Content to Short-Term Outcomes in Individuals at Elevated Breast Cancer Risk

Few studies have linked actual genetic counseling content to short-term outcomes. Using the Self-regulation Model, the impact of cognitive and affective content in genetic counseling on short-term outcomes was studied in individuals at elevated risk of familial breast-ovarian cancer. Surveys assessed dependent variables: distress, perceived risk, and 6 knowledge measures (Meaning of Positive Test; Meaning of Negative Test; Personal Behavior; Practitioner Knowledge; Mechanisms of Cancer Inheritance; Frequency of Inherited Cancer) measured at pre- and post-counseling. Proportion of participant cognitive and affective and counselor cognitive and affective content during sessions (using LIWC software) were predictors in regressions. Knowledge increased for 5 measures and decreased for Personal Behavior, Distress and Perceived Risk. Controlling for age and education, results were significant/marginally significant for three measures. More counselor content was associated with decreases in knowledge of Personal Behavior. More participant and less counselor affective content was associated with gains in Practitioner Knowledge. More counselor cognitive, and interaction of counselor cognitive and affective content, were associated with higher perceived risk. Genetic counselors dominate the content of counseling sessions. Therefore, their content is tied more closely to short term outcomes than participant content. A lack of patient communication in sessions may pose problems for understanding of complex concepts.     

The Place of Philosophy in Africa

Recently there has been a strong movement towards reflections about the “geography of reason,” especially among philosophers who deal with postcolonial thinking. There is also a renewed interest among different schools of thought, both analytical and continental, in the ways our “life world,” or “embodiment,” or “situated cognition,” shape our minds and eventually the philosophy we do. As a result, we have seen some recent publications on the nature and import of the concept of “place” by authors such as Edward Casey, Jeff Malpas, and Bruce Janz. In Philosophy in an African place, Bruce Janz introduces the concept of “philosophy‐in‐place” with the question as to what it is to do philosophy in a particular context of lived experience or, more specifically, what it is to do philosophy in an African place. This paper expands on Janz's “philosophy‐in‐place” by developing what will be called a “philosophy through place.” It starts with Janz's discussion of the problem of placing philosophy and a philosophy‐in‐place. Then it attempts to develop an argument for a “philosophy through place” and its implications for considering the place of philosophy in Africa and the challenge it poses to philosophy.