Psychological Reactance as a Factor in Patient Noncompliance With Medication Taking: A Field Experiment1

Patient noncompliance with medical recommendations is widespread. The theory of psychological reactance sheds light on the subject. Reactance theory posits that when an individual discems a threat to a valued freedom, a motivational state compels the individual to reassert that freedom. The present study sought evidence of reactance in the compliance behaviors of 101 patients. Participants were exposed to either an authoritative‐oriented or a partnership‐oriented advice‐giving tone, coupled with either an opportumity for the participant to select certain features of the regimen or no opportunity to do so. While neither manipulation produced the anticipated causal results, both quantitative and qualitative correlational data clearly revealed a connection between reactance and noncompliance. The investigators report findings and make suggestions for further research.     

Self-Determination and Empowerment: A Feminist Standpoint Analysis of Talk about Disability

In this paper we offer a feminist analysis of talk about self-determination and empowerment in the context of disability, focusing on the case of developmental disabilities. We find strains of the same patterns feminist epistemologists have argued shape the organization of formal knowledge from the standpoint of the privileged. At the extreme, people with developmental disabilities appear as objects without selves, outside of the context of interpersonal and social structural relationships that constrain who they can be by defining them as other, often in multiple and interacting ways. Empowerment, from the dominant standpoint, becomes an abstract attribute or condition; something a person has or does not have. Taking the standpoint of women and other marginalized people offers a view of self-determination as a person's development of his or her self. Empowerment becomes a potential characteristic of a social relationship, one that facilitates the development of someone's self. The most empowering relationships are mutual, recognizing and building on the diverse contributions and needs of participants in ways that seek to minimize inequalities over time. The reason some of us are self-determining is that we are in interpersonal and social structural relationships that empower us. To construct interpersonal and social structural relationships that empower people with developmental disabilities requires challenging the way dominant conceptualizations of independence and productivity also express the standpoint of the privileged. The standpoint of women allows all of us to talk more of how we connect with and facilitate one another's developing selves within communities.     

Adolescents' Possible Selves and Their Relationship to Global Self-Esteem

Recent research indicates that adolescent girls'self-esteem is lower than that of boys, and adolescence has been identified as a particularly problematic period for female self-esteem. However, many studies use global self-esteem measures that mask important differences within the domains of self-concept that contribute to self-esteem. Further, some self-esteem measures assess components of male self-esteem but overlook aspects of female self-esteem. The possible selves approach was used to identify categories of adolescent male and female self-concept that correlate with self-esteem. Subjects were 212 high-school students. The sample was primarily (96%)Caucasian. Results indicate that female self-esteem is related to perceived likelihood of hoped-for and feared possible selves in multiple domains, whereas male self-esteem is related only to the likelihood of one domain of hoped-for possible selves.     

Sexual Risk-Taking Behaviors Among Adolescents with Severe Emotional Disturbance

We investigated the sexual risk-taking behaviors of adolescents with severe emotional disturbance (SED). Subjects (N = 70) were clients of the South Carolina Continuum of Care. Information on sexual intercourse, sexual risk-taking, aggressive behaviors, substance use, and suicidal behavior was gathered using a modified version of the US Centers for Disease Control and Prevention self-report Youth Risk Behavior Survey. Forty-two percent of each race-gender group reported first intercourse before age 13, except for African American females at 63%. Seventy-five to 79% of all race-gender groups reported first sexual intercourse by age 18. Drinking alcohol before age 13 and carrying a weapon in the past 30 days were associated with first intercourse before age 13. Youth reporting first intercourse between ages 13 and 18 were about 12 times more likely to report suicide ideation than those youth who reported never having sexual intercourse. Youth with SED reporting first intercourse before age 13 appear to have an increased risk for unintended pregnancy and for contracting a sexually transmitted disease compared to youth with SED reporting first intercourse after age 13.     

Environmental factors and sense of community in a planned town

Previous community psychology research has suggested that sense of community can be a powerful explanatory tool for understanding community development and individual well-being, but has not focused on the relationship of environmental variables to the construct. In other disciplines—especially urban planning—this construct has received more attention but it has not been empirically and systematically studied. The three-phase qualitative study reported here sampled people representative of those who live and work in Seaside, FL, a town designed to induced sense of community. The data strongly suggest a relationship between a variable set that may define sense of community—membership, need fulfillment, shared emotional connections, loyalty—and the environmental variables of town design, architecture, and urban planning philosophy.     

The declining job satisfaction of white-collar women in sex-segregated and mixed-sex occupations

The declining job satisfaction of women white-collar workers reported by J. Veroff, E. Douvan, and R. A. Kulka (1981, The Inner American: A self-portrait from 1957 to 1976, New York, Basic Books) is explored through secondary analyses of their data from two national cross-sectional surveys conducted in 1957 and 1976. Analyses were done using data from 258 women in 1957 and 372 women in 1976 in white-collar jobs. Multivariate contingency table analyses were used first to explore the separate effects of type of white-collar employment, whether or not the job was sex segregated, age, birth cohort, and education on job satisfaction declines. The decline in job satisfaction was found to be greater for women in sex-segregated occupations that in mixed-sex ones. In addition, while all white-collar women express increased dissatisfaction with ego-involving aspects of work, those in sex-segregated fields showed the greatest increases in job dissatisfactions in affiliative and achievement spheres. Neither type of white-collar employment nor birth cohort related to differential job satisfaction declines though age and education changes did. The final multivariate analysis demonstrated that the changing age and educational characteristics of job holders in sex-segregated fields accounted for the greater job satisfaction declines for these women, and that sex segregation did not appear to affect job satisfaction beyond changes related to these demographic factors.     

Self-punitive behavior with changing percentages of reinforcement: The proper role of discrimination

Past research on self-punitive behavior has been interpreted as supporting a theoretical éxplanation based on a vicious circle rather than a discrimination hypothesis. Using rats, Melvin (1964) found that self-punitive behavior is not reduced when discrimination is aided by changing the percentage of shock trials from acquisition to extinction. This past research is inconclusive because it is based on a misinterpretation of what is the critical discrimination for extinction, namely the new response-punishment contingency. Using humans, the present study provides evidence that subjects can and do discriminate the change in percentage, but continue to show self-punitive behavior until they make the discrimination that responding results in shock rather than escape.     

Psychological androgyny and college students' judgments of mental health

College students' perceptions of the mental health of men and women were examined in comparison to an adult health standard. Two hundred forty male and female undergraduates were asked to describe a socially competent healthy adult man, healthy adult woman, or a healthy adult (sex unspecified) using the Bem Sex-Role Inventory, which provides a measurement of androgyny as well as masculinity and femininity. In accordance with the Broverman, Broverman, Clarkson, Rosenkrantz, and Vogel (1970) study of clinicians' perceptions, the healthy man was described as similar to the adult standard, while the healthy woman was not. Unlike the Broverman et al. (1970) study, the male but not the female subjects perceived the healthy woman as different, suggesting that college women may be less likely to endorse sex-linked conceptions of mental health than their male counterparts.