An R package for state-trace analysis

State-trace analysis (Bamber, Journal of Mathematical Psychology, 19, 137-181, 1979) is a graphical analysis that can determine whether one or more than one latent variable mediates an apparent dissociation between the effects of two experimental manipulations. State-trace analysis makes only ordinal assumptions and so, is not confounded by range effects that plague alternative methods, especially when performance is measured on a bounded scale (such as accuracy). We describe and illustrate the application of a freely available GUI driven package, StateTrace, for the R language. StateTrace automates many aspects of a state-trace analysis of accuracy and other binary response data, including customizable graphics and the efficient management of computationally intensive Bayesian methods for quantifying evidence about the outcomes of a state-trace experiment, developed by Prince, Brown, and Heathcote (Psychological Methods, 17, 78-99, 2012).     

Cognitive pitfall! Videogame players are not immune to dual-task costs

With modern technological advances, we often find ourselves dividing our attention between multiple tasks. While this may seem a productive way to live, our attentional capacity is limited, and this yields costs in one or more of the many tasks that we try to do. Some people believe that they are immune to the costs of multitasking and commonly engage in potentially dangerous behavior, such as driving while talking on the phone. But are some groups of individuals indeed immune to dual-task costs? This study examines whether avid action videogame players, who have been shown to have heightened attentional capacities, are particularly adept multitaskers. Participants completed three visually demanding experimental paradigms (a driving videogame, a multiple-object-tracking task, and a visual search), with and without answering unrelated questions via a speakerphone (i.e., with and without a dual-task component). All of the participants, videogame players and nonvideogame players alike, performed worse while engaging in the additional dual task for all three paradigms. This suggests that extensive videogame experience may not offer immunity from dual-task costs.     

The experiences and understandings of obesity: Families’ decisions to attend a childhood obesity intervention

Objectives: This study investigated the families’ experiences of a childhood obesity intervention and sought to understand factors that influence attendance and lifestyle behaviours.

Design: Eleven semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis.

Results: Four themes emerged highlighting the differences and similarities between attendees and non-attendees perceptions of childhood obesity, perceptions of the intervention, practical barriers and overcoming hurdles to attending and, availability and suitability of local facilities.

Conclusions: The findings relate to identity and health communication. For some families attending an obesity intervention may challenge social and individual identities, which may have an impact on subsequent behavioural decisions. Those who attend the obesity intervention may experience a shift in identity, which may or may not initially be perceived as a positive outcome. Public Health and those involved in treatment interventions should aim to bridge the gap between people’s in-group identities and those associated with particular lifestyle behaviours. In order to be effective, services must meet the needs of their clients and address any preconceived negative perceptions by carefully considering how health information is presented, how it is understood and most importantly how identity may affect motivation to engage in, and sustain, new behaviours.     

Change and processes of change within interventions to promote adjustment to multiple sclerosis: Learning from patient experiences

This qualitative study was nested within a trial of cognitive behaviour therapy (CBT) and supportive listening for patients with multiple sclerosis (MS). It aimed to enrich understanding of the changes made during therapy and to explore processes of change. In-depth interviews with 30 participants from the treatment trial were analysed inductively and five main themes were developed. The benefits that participants described experiencing as a result of the interventions were highly variable, idiosyncratic and often departed from outcomes measured within the trial. Tuning into and sharing one’s thoughts and feelings and learning specific strategies for living with MS appeared to be important processes for change, and participants identified the latter as particularly important for sustaining long-term benefits from therapy. Whether participants fully engaged with the interventions appeared to be related to their perceptions of being the right sort of candidate for the intervention, their expectations and motivations, the therapeutic relationship, adequate tailoring of the intervention, and practical issues. This study builds on previous research on factors and processes involved in adjustment to MS, the benefits of CBT for this population and highlights important issues to consider when developing psychosocial interventions for people with MS.     

Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management

This study examines the effectiveness of a brief self-management intervention to support patients recently diagnosed with type-2 diabetes to achieve sustained improvements in their self-care behaviours. Based on proactive coping, the intervention emphasizes the crucial role of anticipation and planning in maintaining self-care behaviours. In a randomised controlled trial among recent screen-detected patients, participants who received the intervention were compared with usual-care controls, examining changes in proximal outcomes (intentions, self-efficacy and proactive coping), self-care behaviour (diet, physical activity and medication) and weight over time (0, 3 and 12 months). Subsequently, the contribution of proactive coping in predicting maintenance of behavioural change was analysed using stepwise hierarchical regression analyses, controlling for baseline self-care behaviour, patient characteristics, and intentions and self-efficacy as measured after the course. The intervention was effective in improving proximal outcomes and behaviour with regard to diet and physical activity, resulting in significant weight loss at 12 months. Furthermore, proactive coping was a better predictor of long-term self-management than either intentions or self-efficacy. Proactive coping thus offers new insights into behavioural maintenance theory and can be used to develop effective self-management interventions.     

Self-affirmation moderates effects of unrealistic optimism and pessimism on reactions to tailored risk feedback

We examined whether self-affirmation would facilitate intentions to engage in colorectal cancer (CRC) screening among individuals who were off-schedule for CRC screening and who were categorised as unrealistically optimistic, realistic or unrealistically pessimistic about their CRC risk. All participants received tailored risk feedback; in addition, one group received threatening social comparison information regarding their risk factors, a second received this information after a self-affirmation exercise and a third was a no-treatment control. When participants were unrealistically optimistic about their CRC risk (determined by comparing their perceived comparative risk to calculations from a risk algorithm), they expressed greater interest in screening if they were self-affirmed (relative to controls). Non-affirmed unrealistic optimists expressed lower interest relative to controls, suggesting that they were responding defensively. Realistic participants and unrealistically pessimistic participants who were self-affirmed expressed relatively less interest in CRC screening, suggesting that self-affirmation can be helpful or hurtful depending on the accuracy of one's risk perceptions.     

Individual differences,mood, and coping with Chronic pain in Rheumatoid Arthritis: a daily process analysis

This study examines individual differences in coping and associated health outcomes as they unfold across time. Twice daily for one week, 71 individuals with Rheumatoid Arthritis reported their pain, coping efforts, and negative mood via structured daily records. The five factor model of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) and disease status were also assessed. Multi-level statistical models examining within and between person variability indicated significant temporal associations from coping to pain and bi-directional associations between mood and pain within days. Furthermore, findings suggest that coping use and coping effectiveness were moderated by personality. Implications for models of coping with chronic pain, as well as clinical applications, are discussed.     

‘It's like there are two people in my head’: A phenomenological exploration of anorexia nervosa and its relationship to the self

This study explores the lived experience of anorexia nervosa from the perspective of those who use pro-recovery websites for eating disorders. Fourteen people participated in an online focus group or an e-interview. Data were analysed using interpretative phenomenological analysis. Participants described their disorder as a functional tool for avoiding and coping with negative emotions, changing their identity and obtaining control. A central theme was the experience of an ‘anorexic voice’ with both demonic and friendly qualities. This voice felt like an external entity that criticised individuals and sometimes dominated their sense of self, particularly as anorexia nervosa got worse. Applying dialogical theory suggests a new model of anorexia nervosa, where the anorexic voice is a self-critical position, which disagrees with and attempts to dominate the more rational self. It is suggested that to move on from anorexia nervosa, the individual needs to address his/her anorexic voice and develop a new dominant position that accepts and values his/her sense of self.     

Counsellor-delivered HIV risk reduction intervention addresses safer sex barriers of people living with HIV in KwaZulu-Natal,South Africa

This study developed an HIV risk reduction intervention for people living with HIV (PLWH) obtaining care at primary healthcare clinics in KwaZulu-Natal, South Africa by (1) conducting elicitation research to understand the dynamics of risk behaviour among PLWH, (2) modifying an existing HIV risk reduction intervention based on research findings and (3) conducting a pilot study to evaluate feasibility, acceptability and fidelity of the modified intervention implemented by trained lay counsellors at a rural clinic in KwaZulu-Natal. A total of 61 healthcare providers and 77 HIV+ patients from four primary healthcare clinics participated in 14 focus groups and 20 individual interviews to identify informational, motivational and behavioural skills (IMB) factors contributing to PLWH's sexual risk behaviour. Elicitation research findings were incorporated into a revised version of Options for Health, an evidence-based risk reduction intervention for PLWH in clinical care. In a 5-day training, lay counsellors learned strategies to address IMB barriers to safer sex identified in elicitation research. The revised intervention, which was implemented by six counsellors with 39 patients, was feasible to implement, acceptable to patients and counsellors, and implemented with good fidelity. This study makes an important contribution towards development of a theory-based HIV risk reduction intervention for PLWH linking prevention with treatment in South Africa.