Not doing is not the opposite of doing: implications for attitudinal models of behavioral prediction

This study argues for and tests the prediction that cognitions about not performing a behavior are not simple opposites of cognitions about performing the same behavior because they rely on separate goals. Three behaviors (i.e., eating meat, doing vigorous physical activity, and breastfeeding) are examined, for which performing and not performing are means to different goals. In the context of the theory of planned behavior, the discriminant validity of constructs related to performing and not performing behaviors is tested. Moreover, the simultaneous validities of perceived behavioral control over doing and not doing for the prediction of both intentions and the incremental validity of both intentions in predicting behavior are investigated. Results show that the constructs related to performing and not performing a behavior independently contribute to the prediction of intentions and behaviors. Implications of considering separable motivational systems underlying doing and not doing are discussed.     

Everyday creative activity as a path to flourishing

Recent experience sampling and diary studies have shown that spending time on creative goals during a day is associated with higher activated positive affect (PA) on that day. Based on models of creativity as a tool for promoting well-being, the present study examined cross-day relationships between creative activity, affect, and flourishing. A large sample of young adults (n = 658) took part in a 13-day daily diary study. Each day, they reported how much time they spent on creative activities, daily positive and negative affect, and daily flourishing. Lagged multilevel models revealed that people felt higher activated PA and flourishing following days when they reported more creative activity than usual. The other direction – PA predicting next-day creative activity – was not supported, suggesting that the cross-day effect was specific to creative activity predicting well-being. Overall, these findings support the emerging emphasis on everyday creativity as a means of cultivating positive psychological functioning.     

Poisoning Severity Associated with a Range of Medications in Suicide Attempts by Ingestion

There are limited data on the medical severity of suicide attempts by intentional self‐poisoning (ISP) associated with ingestion of differing classes of medications and meager data on specific agents. The purpose of the study was to address these gaps. This was an analysis of a consecutive series of ISP cases ages 13 to 65 treated at a U.S. university medical center (N = 671). The outcome, poisoning severity, was dichotomized as “moderate‐severe” and “low” (reference) based on a standard measure. Class of medication (e.g., opiate) and specific agents ingested were the predictors of interest. Covariates were age, sex, and the ingestion of multiple classes of medications. Data were analyzed using multivariate logistic regression models. At the class level, ingestion of opiate was uniquely associated with increased risk for moderate‐severe ISP at a statistically significant level, adjusted odds ratio (95% CI) = 2.97 (1.69, 5.21), p = .0002. Several specific agents were also associated with moderate‐severe ISP. Along with the key role of opiate medications in unintentional overdose morbidity and mortality, opiate medications may also play an important and largely unrecognized role in medically serious suicidal behavior. Results also underscore the variability in toxicity of specific agents within drug classes.     

Metaanalysis of Mood and Substance Use Disorders in Proximal Risk for Suicide Deaths

Evidence for proximal risk factors for suicide is based on case–control psychological autopsy studies, with these reports showing that mood and substance use disorders are the most prevalent mental disorders among suicide decedents worldwide and are associated with marked risk. However, moderators of risk and the degree of risk associated with (nonalcohol) drug use disorder are unknown. A comprehensive search was used to identify 35 case–control psychological autopsy studies published worldwide over a 30‐year period that were metaanalyzed using random effects models. Major depression, odds ratio (95% confidence interval) = 9.14 (5.53, 15.09), and drug use disorder, OR (95% CI) = 7.18 (3.22, 16.01), had large effect sizes, among other results. Risk estimates associated with major depression were greater in studies with a larger proportion of women and those conducted in Asia compared with other regions. There was no evidence of publication bias or that any one study had a disproportionate impact on findings. Risk for suicide associated with major depression appears to be moderated by sex and/or world region. Drug use disorder is a potent risk factor, illustrating the importance of assessing drug use in clinical risk assessment.     

Comparison of Behavioral Belief Structures in the Physical Activity Domain

Behavioral belief structures were evaluated in the physical activity domain along 4 dimensions: positive–negative, affective–instrumental, distal–proximal, and specific motive. Participants completed 19 behavioral belief items and a measure of intention. These behavioral beliefs were subsequently classified on each dimension by 2 independent judges. Results using structural equation modeling showed that positive–negative, affective–instrumental, and proximal–distal dimensions each improved fit over a single behavioral belief construct. Division by affective–instrumental and positive–negative yielded the best fit, compared to single dimensions, but no division resulted in adequate model fit. Indeed, fit continued to improve as each dimension was added, but this specificity came with incumbent multicollinearity when trying to use the constructs for prediction purposes.     

Individual and collaborative implementation intentions and the promotion of breast self-examination

Implementation intentions, plans relating to when and where behaviours will be performed, have been effective in increasing health behaviour. Two studies are reported that test the impact of this strategy in promoting breast self-examination (BSE), a behaviour shown to aid the early detection of tumours. In study 1, 457 participants were randomly allocated to either implementation intention or control conditions. Implementation intentions significantly increased the likelihood of BSE at one month. The effect of the intervention was marginally significant at six months. Study 2 (N?=?101) tested the efficacy of a collaborative implementation intention intervention that required female participants to plan, with a partner, collaborative BSE performance. Results indicated that both implementation intentions and partner involvement were associated with BSE performance at one month, whilst the collaborative implementation intention intervention showed a 100% success rate. Collaborative implementation intentions may reduce forgetfulness. Interventions that encourage partner involvement in planning and enacting behaviour appear to enhance implementation intention utility.     

Moderator effects of attitudinal ambivalence on attitude–behaviour relationships

Attitudinal ambivalence is generally construed as existing when the same attitude object is evaluated simultaneously as both positive and negative. The present research examined the moderating role of attitudinal ambivalence (as assessed by split‐semantic differential measure) on the relationship between bipolar semantic differential measures of attitude and subsequent behaviour using moderated regression analysis. In Study 1, higher levels of attitudinal ambivalence were shown to result in weaker attitude–behaviour relationships for eating a low‐fat diet (N = 140) and eating 5 portions of fruit and vegetables per day (N = 142). Study 2 (N = 361) replicated this effect when also including a measure of past behaviour for eating a low‐fat diet. Implications for understanding the relationship between attitudes and behaviour are discussed. Copyright © 2002 John Wiley & Sons, Ltd.     

Expanding the traditional user versus non‐user dichotomy amongst ecstasy users

Differences in the drug use characteristics and psychosocial variables in the use and non‐use of ecstasy within 845 16–25 year‐olds in the UK was examined. Based on levels of ecstasy use and intentions, two groups of non‐users (resistant and vulnerable), three groups of users (light, moderate and heavy) and an ex‐user group were identified. It was found that there is predictive utility in this way of expanding the widely employed ‘user versus non‐user’ dichotomy. Resistant non‐users were more likely to be younger, female, and were characterized by lower levels of use of four other drugs (amphetamine, cannabis, cocaine and LSD). Those ‘at risk’ of using ecstasy reported more frequent use of amphetamine, LSD, and cannabis than resistant non‐users. Heavy user groups reported using amphetamine, cocaine and LSD more frequently than all the other groups. Having ecstasy using friends increased the odds of being an ‘at risk’ non‐user or an ecstasy user. Normative influence also differentiated between the three user groups (light, moderate, and heavy). Beliefs about ecstasy use being immoral, ecstasy offers being difficult to resist, ecstasy use making one feel guilty and ecstasy being readily available differentiated between user and non‐user groups. These factors could usefully inform the content of health education materials designed to change ecstasy use. Copyright © 2003 John Wiley & Sons, Ltd.