Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory.     

Naturalistic evaluation of suicidal ideation: variability and relation to attempt status

Suicidal ideation has been thought to have a relatively stable course across weeks and months. However, daily changes in levels of ideation have not been adequately examined despite the importance of potential variability clinically and conceptually. For example, it has been suggested that variability in suicidal ideation may become less closely tied to variability in other mood symptoms (e.g., depression, hopelessness) among individuals with multiple suicide attempts. The present report had two related goals: (1) to prospectively evaluate suicidal ideation and related mood symptoms, and (2) to determine whether suicide attempt status predicted a decreased association between ideation and other mood symptoms. Non-clinical participants (N=108) with varying levels of suicidal ideation and number of previous suicide attempts completed the beck hopelessness scale (BHS), beck depression inventory (BDI), and suicide probability scale (SPS) every day for 4 weeks. Findings suggested considerable variability in suicidal ideation, especially for multiple attempters. Multiple attempt status predicted a decreased association between suicidal ideation and depression, although the results were only marginally significant. These findings have implications for conceptual models of suicide risk as well as assessment and treatment of suicidal individuals.     

Cross-cultural similarities and differences in North Americans’ geographic location judgments

We examined some potential causes of bias in geographic location estimates by comparing location estimates of North American cities made by Canadian, U.S., and Mexican university students. All three groups placed most Mexican cities near the equator, which implies that all e influenced by shared beliefs about the locationthree groups wers of geographical regions relative to global reference points. However, the groups divided North America into different regions and differed in the relative accuracy of the estimates within them, which implies that there was an influence of culture-specific knowledge. The data support a category-based system of plausible reasoning, in which biases in judgments are multiply determined, and underscore the utility of the estimation paradigm as a tool in cross-cultural cognitive research.     

Competency,and other constructs,in right to die cases

Subjects had to make a “remove” or “do not remove” life-sustaining measures decision in three right to die cases where the patients differed in competence; for half the subjects, a living will was present in all the cases, whereas, for the other half, it was not. Subjects also gave their determinative reasons for their decisions. Support for the right to die varied by case, but not by competency, or by the presence of a living will. The subjects' reasons were highly predictive of their decisions, and related to the way case-specific facts were construed, revealing a number of disparities between the way courts and citizens construe whether the patient's condition is “terminal,” “irreversible,” and “painful,” or not. Beyond construing facts differently, the results also revealed a disparity between evolving case law and the community's “common sense justice” over a fundamental belief: whether dying is seen as private matter, outside the bounds of State intervention, or not.     

Psychoanalytic patients in the U.S., CANADA,and Australia: I. DSM-III-R disorders,indications, previous treatment,medications, and length of treatment

To determine the demographics, DSM-III-R disorders diagnosed, indications used in recommending psychoanalysis, previous treatment histories, use of medication, and length of treatment in patients in psychoanalysis in the U.S., Canada, and Australia, a mail survey of practice was sent to every other active member of the American Psychoanalytic Association and every member of the Australian Psychoanalytical Society. This supplemented an earlier survey sent to all Ontario psychoanalysts. The response rates were 40.1 % (n = 342) for the U.S., 67.2% (n = 117) for Canada, and 73.9% (n = 51) for Australia. Respondents supplied data on 1,718 patients. The employment rate for patients increases as analysis progresses (p < .0001). The mean number of concurrent categories of disorders (Axis I, Axis II, and Disorders First Evident in Childhood) per patient at the start of treatment is 5.01 (SD = 3.66; median = 4; mode = 3). There are no statistically significant differences across countries. Mood, anxiety, sexual dysfunction, and personality disorders are most common. American Psychiatric Association / American Psychoanalytic Association peer review criteria for indicating psychoanalysis are followed for 86.5% of patients. Over 80% of patients in all three countries had undergone previous treatments prior to analysis. In the U.S., 18.2% of analysands are on concurrent psychoactive medication; in Australia, 9.6%. The mean length of analyses conducted in the U.S. is 5.7 years, in Australia 6.6, and in Canada 4.8. Psychoanalytic patients in all three countries have similar rates of DSM-III-R psychopathology, and many indications of chronicity.