A new typology of health behaviours for personality-health predictions: The case of locus of control

Psychological investigations of the impact of personality on health behaviours have tended to emphasize fine distinctions among personality variables while failing to distinguish among different kinds of behaviours. For example, theoretical treatments of perceived personal control are quite sophisticated; in contrast, only one well-known analysis of health behaviours exists. We propose four categories of health-enhancing behaviours, which take into account contemporary views of the shift in health care from acute and physician-directed actions to long-term and patient-directed efforts. In addition, we suggest that perceived control (we emphasize locus of control because of its generality and parsimony) is an important predictor variable when combined with other factors common to current models of health behaviour.     

Random error in additive decompositions of multiattribute utility

Decomposition is a common strategy for dealing with the complexity of multiattribute decision problems. A cognitively demanding task is broken down into tasks requiring simpler, perhaps easier, judgments which can then be aggregated. But individual judgments can be inconsistent in systematic or random fashion and when aggregated there is the possibility of propagation of this inconsistency. In this paper inconsistency in the form of random error is investigated in the context of additive decomposition of multiattribute utility. The process of aggregation of random error is studied and a comparison made with random error in holistic estimates of multiattribute utility. Conditions under which decomposition improves the consistency of the multiattribute utility estimate are presented and discussed.     

Personality, stress, smoking, and genetic predisposition as synergistic risk factors for cancer and coronary heart disease.

Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD).     

Does anxiety or cardiovascular reactivity have a causal role in hypertension?

Anxiety, stress, and cardiovascular reactivity (CVR) are variously believed to play a role in sustained hypertension. Although acute anxiety or stress elicits acute pressor responses, there is little support for their significant role in sustained hypertension. Anxiety correlates poorly with CVR, and blood pressure levels and anxiolytics do not sustain blood pressure lowering in subjects with hypertension-associated anxiety. Chronic anxiety disorders tend to be characterized by relatively low blood pressure and prevalence of sustained hypertension. Blood Pressure Regulation in hypertension is normal, and normo- and hypertensives have similar ambulatory blood pressure variability. Laboratory CVR fails to predict variability in natural environments, hyperreactors do not exhibit increased variability in natural environments, and the increased variability and ambulatory reactivity that is "accounted for" by laboratory responses is small. These findings do not support the belief that hypertension is related to a summation of heightened pressor responses over time. Antihypertensives normalize elevated blood pressures but do not alter CVR in the laboratory or variability in natural environments, probably because of a dual central regulation of resting and reactive blood pressures. Psychological stress responses result from selective neuronal activation rather than from generalized sympathetic neural responses or dysregulation. Differences in blood pressure responses during various emotions are only quantitative, with no specificity of sympathoadrenal or emotional responses to stressors. It may be time to regard reactive cardiovascular responses as physiological, rather than as psychological, and to require much stronger evidence to confirm causal roles of anxiety, stress, and reactivity in sustained hypertension.     

Conversational skills training with a chronically hospitalized psychiatric inpatient

While conversational skills training has been conducted with select psychiatric populations, it has rarely been used with severely debilitated inpatients. The purpose of this study was to use a multiple baseline design across conversational components to evaluate the effectiveness of a conversational skills training package to enhance the conversational repertoire of a severely impaired inpatient. Audiotaped conversations with a standard confederate were evaluated for the frequency of questions, self-disclosures, and reinforcing/acknowledging comments. Generalization probe conversations to novel partners were also obtained. Training effects were noted for the 3 conversational units. Mixed results were obtained for generalization and follow-up.