Health decision making and behavior: The role of affect‐laden constructs

A common criticism of social cognitive models predicting health behavior is their exclusion of affect—an important component of individual‐level decision processes for behavior change. Yet the role of affect, and its interaction with cognitions, is complex. We provide an overview of affect and pathways through which it is proposed to influence outcomes. Then, we discuss several common social cognitive models of health behavior change. Next, we highlight specific affect‐laden constructs (those that incorporate affective and cognitive components) related to health behavior change. We aim to provide clarity on terminology and measurement of the affect‐laden constructs and evidence associating them with health behavior. Finally, we discuss strategies for incorporating these constructs within popular cognitive‐based theories and provide suggestions for future work.     

Acute Stimulant Treatment and Reinforcement Increase the Speed of Information Accumulation in Children with ADHD

The current studies utilized drift diffusion modeling (DDM) to examine how reinforcement and stimulant medication affect cognitive task performance in children with ADHD. In Study 1, children with (n = 25; 88 % male) and without ADHD (n = 33; 82 % male) completed a 2-choice discrimination task at baseline (100 trials) and again a week later under alternating reinforcement and no-reinforcement contingencies (400 trials total). In Study 2, participants with ADHD (n = 29; 72 % male) completed a double-blind, placebo-controlled trial of 0.3 and 0.6 mg/kg methylphenidate and completed the same task utilized in Study 1 at baseline (100 trials). Children with ADHD accumulated information at a much slower rate than controls, as evidenced by a lower drift rate. Groups were similar in nondecision time and boundary separation. Both reinforcement and stimulant medication markedly improved drift rate in children with ADHD (ds = 0.70 and 0.95 for reinforcement and methylphenidate, respectively); both treatments also reduced boundary separation (ds = 0.70 and 0.39). Reinforcement, which emphasized speeded accuracy, reduced nondecision time (d = 0.37), whereas stimulant medication increased nondecision time (d = 0.38). These studies provide initial evidence that frontline treatments for ADHD primarily impact cognitive performance in youth with ADHD by improving the speed/efficiency of information accumulation. Treatment effects on other DDM parameters may vary between treatments or interact with task parameters (number of trials, task difficulty). DDM, in conjunction with other approaches, may be helpful in clarifying the specific cognitive processes that are disrupted in ADHD, as well as the basic mechanisms that underlie the efficacy of ADHD treatments.     

Loneliness as Moderator Between Trauma and Posttraumatic Growth

This study investigated the association between loneliness, trauma symptomatology, and posttraumatic growth (PTG) in undergraduate students (N = 362). The study also explored whether loneliness moderated the relationship between experiences of trauma and PTG. The results demonstrated that both loneliness and trauma symptoms predicted levels of PTG, and loneliness moderated the relationship between trauma and PTG. Limitations, directions for future research, and implications for counseling are discussed.     

Assessment of the Language Preferences of Five Children with Autism from Spanish-Speaking Homes

Although the number of English Language Learner students is increasing in the US school system, little is known about the preferences of language of instruction, particularly among young students with autism. We implemented a choice assessment with five children with autism to determine preference between English and Spanish instruction using a concurrent-operant design. Participants were allowed to choose between English instruction, Spanish instruction, and a no-language control condition using BIGmack communication devices. We compared choice allocation between previously mastered skills (easy tasks) and targets in the acquisition phase of learning (difficult tasks). None of the participants indicated a preference for language of instruction during easy tasks, while four participants indicated a preference during difficult tasks. Results suggest that the concurrent-operant procedure is an effective method for assessing preference of language of instruction with students with autism.     

Parents’ Reports of Children’s Internalizing Symptoms: Associations with Parents’ Mental Health Symptoms and Substance Use Disorder

This brief report examined the unique associations between parents’ ratings of child internalizing symptoms and their own depression and anxiety in families with parental substance use disorder (SUD). Further, we examined whether parental SUD (father only, mother only, both parents) was related to discrepancy in mothers’ and fathers’ reports of children’s internalizing symptoms. Participants were 97 triads (fathers, mothers) in which one or both parents met criteria for SUD. Polynomial regression analyses were conducted to examine whether father-mother reports of child internalizing symptoms had unique associations with parents’ own symptoms of depression and anxiety while controlling for child gender, child age, and SUD diagnoses. Controlling for fathers’ symptoms and other covariates, mothers experiencing more depression and anxiety symptoms reported more symptoms of child internalizing symptoms than did fathers. Mothers’ and fathers’ SUD was associated with higher anxiety symptoms among mothers after controlling for other variables. A second set of polynomial regressions examined whether father-mother reports of child internalizing symptoms had unique associations with parents’ SUD diagnoses while controlling for child gender and child age. After controlling for mothers’ symptoms and other covariates, parents’ reports of children’s internalizing symptoms were not significantly associated with either parent’s SUD or parental SUD interactions (i.e., both parents have SUD diagnoses). Taken together, mothers’ ratings of children’s internalizing symptoms may be accounted for, in part, by her reports of depression and anxiety symptoms.     

The DSM‐IV‐TR and Culture: Considerations for Counselors

Although counselors receive training in both diagnosis and cultural foundations of human behavior, little literature or research integrates these 2 areas in order to facilitate culturally sensitive diagnostic practices. The authors attempt to rectify that lack by providing a review of the literature on the controversies associated with traditional diagnosis of cultural groups that differ from the dominant culture. Practical guidelines for culturally sensitive diagnosis are provided.     

Quantitative EEG Assessment During Neuropsychological Task Performance in Adults with Attention Deficit Hyperactivity Disorder

This study evaluated the neuropsychological performance of adults with and without Attention Deficit Hyperactivity Disorder (ADHD) during the Paced Auditory Serial Addition Test (PASAT), Wisconsin Card Sorting Test: Computerized Version 3 (WCST), and the Integrated Visual and Auditory Continuous Performance Test (IVA). Quantitative electroencephalographic (QEEG) data were also collected during task performance to examine differences in cortical activity between groups and tasks. Results suggest that adults with ADHD demonstrated lower levels of performance on the PASAT and IVA, tasks that involve working memory and processing speed, and sustained attention, respectively. Adults with ADHD also had more upper alpha activity during the IVA. Lastly, for the ADHD group, an increased theta/beta ratio during the IVA was significantly related to poorer attentional performance. The current results support reinforcing specific types of cortical activity though EEG operant conditioning (neurofeedback) as a treatment option in adults with ADHD. This paper is based largely in part on a dissertation by J. Noland White in partial fulfillment of the requirements of his doctoral program at The University of Tennessee. Portions of this study have been presented in summary form at several professional conferences.     

Body Dissatisfaction in College Women and Their Mothers: Cohort Effects, Developmental Effects, and the Influences of Body Size, Sexism, and the Thin Body Ideal

A study of body dissatisfaction, as measured by the Figure Rating Scale (Stunkard, Sorenson, & Schlusinger, 1983) and the Body Esteem Scale (Franzoi & Shields, 1984), in 75 college women and their mothers indicated that both daughters and mothers experienced body dissatisfaction. When body size was statistically controlled, either no difference was found between the groups or daughters were found to have greater body dissatisfaction than mothers. The results supported the hypotheses that (1) there are generational differences in body dissatisfaction, (2) both cohort and developmental effects contribute to these differences, and (3) that a developmental effect (mothers' greater body size) may obscure a cohort effect (daughters' greater exposure to the thin body ideal). Body dissatisfaction measures based on the mothers' retrospective ratings of how they felt at their daughters' age were consistent with these hypotheses. Relationships between body dissatisfaction and the Sociocultural Attitudes Toward Appearance Questionnaire (Heinberg, Thompson, & Stormer, 1995) were stronger and more frequent for daughters than for mothers and for the Internalization Scale than for the Awareness Scale. Relationships between the Ambivalent Sexism Inventory (Glick & Fiske, 2001) and body dissatisfaction were stronger for mothers than for daughters and for Benevolent Sexism than for Hostile Sexism.     

An Examination of the Individual‐Difference Approach to the Role of Norms in the Theory of Reasoned Action1

The relationship between subjective norm and behavioral intentions is the weakest link of the theory of reasoned action. Numerous approaches have addressed this issue, including the assertion that the weak contribution is a result of a small number of individuals who are under normative control. The present research examines this individual‐difference approach in the domain of health behaviors. Respondents were 287 students who rated their intentions, attitudes, and subjective norms in relation to 32 health behaviors and 5 substance‐use behaviors. Regression analyses, between subjects and within subjects, demonstrated that both behaviors and people can be under attitudinal or normative control. Support for an individual‐difference approach was less conclusive when findings were examined separately for specific health behaviors.