Concordance between patients' information preferences and general practitioners' perceptions

Brief planning interventions, usually delivered within paper and pencil questionnaires, have been found to be effective in changing health behaviours. Using a double-blind randomised controlled trial, this study examined the efficacy of two types of planning interventions (action plans and coping plans) in increasing physical activity levels when they are delivered via the internet. Following the completion of self-reported physical activity (primary outcome) and theory of planned behaviour (TPB) measures at baseline, students (N = 1273) were randomised into one of four conditions on the basis of a 2 (received instructions to form action plans or not) × 2 (received instructions to form coping plans or not) factorial design. Physical activity (primary outcome) and TPB measures were completed again at two-month follow-up. An objective measure (attendance at the university's sports facilities) was employed 6 weeks after a follow-up for a duration of 13 weeks (secondary outcome). The interventions did not change self-reported physical activity, attendance at campus sports facilities or TPB measures. This might be due to low adherence to the intervention protocol (ranging from 58.8 to 76.7%). The results of this study suggest that the planning interventions under investigation are ineffective in changing behaviour when delivered online to a sample of participants unaware of the allocation to different conditions. Possible moderators of the effectiveness of planning interventions in changing health behaviours are discussed.     

The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome

Objective: Partners of acute coronary syndrome (ACS) patients are at risk of experiencing long-term distress and the purpose of this study was to identify its predictors.

Design: Using an observational design, 80 partners of ACS patients completed validated questionnaires at three time points. The predictor variables, marital satisfaction and optimism were assessed three weeks after patient hospital discharge (T1). The outcomes, depressive symptoms and physical health status (from a quality of life scale) were measured 6 (T2) and 12 (T3) months post-discharge, and scores were combined to indicate the long-term response.

Main outcome measures: Depressive symptoms and physical health status.

Results: Partner depressive symptoms increased and physical health status deteriorated over the months following the patients’ ACS. After controlling for demographics, clinical severity of ACS and T1 levels of the outcome variable, partners’ long-term depressive symptoms were predicted by poor marital satisfaction and low optimism at T1, and poor physical health status was predicted by low T1 optimism.

Conclusion: Psychosocial factors are predictors of long-term distress for ACS partners. Partners in an unhappy marriage or with low optimism after ACS are at an increased risk of depression and low physical health status, and should be the target of additional support.     

Cognitive predictors of posttraumatic stress symptoms six months following acute coronary syndrome

This study examined patients’ illness representations assessed shortly after an acute coronary syndrome (ACS) as predictors of posttraumatic stress symptoms six months later. Illness representations were assessed in ACS patients using standard measures at a home visit three weeks after discharge from hospital. Posttraumatic stress symptoms were assessed at the same time, and again six months later. Patients were aged 61 years on average, the majority being men (89.8%) of white European decent (89%). Greater posttraumatic symptoms at six months were associated with beliefs that the illness would last a long time (timeline), that it had an unpredictable time course (timeline – cyclical), greater consequences, less personal and treatment control, poorer illness coherence and stronger negative emotional representations (emotional upset relating to the illness; p?<?0.05). In multiple regression analyses, controlling for demographic, clinical and psychological factors (age, gender, ethnicity, social deprivation, ACS severity, negative affectivity and cardiac symptom recurrence), more intense emotional representations (β?=?0.146, p?=?0.041) and reduced illness coherence (β?=??0.133, p?=?0.029), emerged as independent predictors of posttraumatic symptom severity at six months. There was a near significant effect for personal control (β?=??0.113, p?=?0.058). These results demonstrate the importance of illness representations of ACS in predicting longer-term posttraumatic stress symptoms.     

Confirmatory Factor Analysis of the Behavior Rating Inventory of Executive Function (BRIEF) in a Clinical Sample

Evidence for the validity of the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, & Kenworthy, 2000) based on internal structure was examined in a sample of children with mixed clinical diagnoses via maximum likelihood confirmatory factor analysis. Four alternative factor models of children's executive function, based on current theories that posit a unidimensional versus fractionated model (Rabbitt, 1997; Shallice & Burgess, 1991), using the revised 9-scale BRIEF configuration that separates two components of the Monitor scale, were examined for model fit. A 3-factor structure best modeled the data when compared directly with 1-, 2-, and 4-factor models. The 3-factor model was defined by a Behavior Regulation factor consisting of the BRIEF Inhibit and Self-Monitor scales, an Emotional Regulation factor consisting of the Emotional Control and Shift scales, and a Metacognition factor composed of the Working Memory, Initiate, Plan/Organize, Organization of Materials, and Task-Monitor scales. The findings support a fractionated, multi-component view of executive function as measured by the BRIEF.     

Appetitive and Defensive Arousal in Violent Video Games: Explaining Individual Differences in Attraction to and Effects of Video Games

Evidence surrounding the attraction to media violence is mixed and the effects of violent video game play on players varies across experimental participants. Differences in both may be explained by differences in experienced positive or negative arousal. This study utilizes the limited capacity model of motivated mediated message processing (LC4MP) and the motivation activation measure (MAM), which measures resting activation of the appetitive and aversive arousal systems, to explore the relationship between attraction to media violence, arousal, and aggression. In part 1, a questionnaire found that men and frequent players of violent games expected to enjoy violent games more than nonviolent games. In addition, participants whose scores on the MAM characterized them as risk takers (high scores on appetitive arousal and low scores on aversive arousal) indicated a stronger preference for violent games compared to the other three arousal types, which is in line with the LC4MP. In the experimental portion of the research, after playing a violent game, those participants characterized as risk avoidant (high on aversive arousal and low on appetitive arousal) were significantly less aggressive than all other arousal groups. Overall, results show that individual differences in the appetitive and aversive arousal systems can explain attraction to violent media. Furthermore, arousal resulting from violent video game play can be experienced as pleasant or aversive, and it is this experience of arousal that explains variations in aggressive responses to violent video games.     

Response to bitter substances in primates: Roles of diet tendency and weaning age

In primates, the perception of bitter taste may be an essential mechanism for avoiding the ingestion of bitter, and often toxic, substances. Bitterness sensitivity varies across the different primate species and, for bitter thioure substances (e.g., phenylthiocarbamide—PTC), within species. Primates respond to bitterness by displaying aversive affective reactions, and whether these serve for conspecifics as information on the taste of food is still unclear. The aim of this study was to investigate the response to two bitter substances (quinine and PTC) in 11 primate species (N = 29 individuals) hosted at the Ménagerie du Jardin des Plantes, in relation to their main diet tendency and weaning age. We tested primate reactions to bitterness with a two-bottle method. The study individuals showed a strong aversion to bitter taste, minimizing consumption of both bitter solutions. All of the individuals were PTC-taster phenotypes, but the degrees of sensitivity to PTC varied among the individuals. Across-species comparisons revealed that whereas the degree of frugivory of the species had a negative effect on the consumption of bitter solutions by the individuals, a later weaning age seems to be a better predictor for the occurrence of aversive affective reactions. Although the low sample size does not allow for excluding interindividual variability, our results support the hypothesis that affective reactions to bitterness may be trustworthy information for conspecifics during the learning process. Thus, the evolution of the appropriate perceiver systems to convert affective displays into true affective signals could be a shared trait among human and nonhuman primates.     

ANCOVA Versus CHANGE From Baseline in Nonrandomized Studies: The Difference

The pretest-posttest control group design can be analyzed with the posttest as dependent variable and the pretest as covariate (ANCOVA) or with the difference between posttest and pretest as dependent variable (CHANGE). These 2 methods can give contradictory results if groups differ at pretest, a phenomenon that is known as Lord's paradox. Literature claims that ANCOVA is preferable if treatment assignment is based on randomization or on the pretest and questionable for preexisting groups. Some literature suggests that Lord's paradox has to do with measurement error in the pretest. This article shows two new things: First, the claims are confirmed by proving the mathematical equivalence of ANCOVA to a repeated measures model without group effect at pretest. Second, correction for measurement error in the pretest is shown to lead back to ANCOVA or to CHANGE, depending on the assumed absence or presence of a true group difference at pretest. These two new theoretical results are illustrated with multilevel (mixed) regression and structural equation modeling of data from two studies.     

Self-reported sources of stress in senior high school students

The main sources of stress reported by 423 Australian final-year high school students using the Academic Stress Questionnaire were school-related as expected. The highest sources of this stress were examinations and outcomes, too much to do, worry over future, making choices about career, studying for examinations, amount to learn, need to do well imposed by others, and self-imposed need to do well.