Evaluating Theories of Health Behavior Change: A Hierarchy of Criteria Applied to the Transtheoretical Model

The most common criteria recommended by philosophers of science for evaluating theories were organised within a hierarchy ranging from the least to the most risky tests for theories of health behavior change. The hierarchy progressed across: (1) Clarity; (2) Consistency; (3) Parsimony; (4) Testable; (5) Predictive Power; (6) Explanatory Power; (7) Productivity; (8) Generalisable; (9) Integration; (10) Utility; (11) Efficacy; and (12) Impact. The hierarchy was applied to the Transtheoretical Model (TTM) as an example of a health behavior change theory. The application was from the perspective of critics and advocates of TTM. Examples of basic and applied research challenging and supporting TTM across the hierarchy of criteria are presented. The goal is to provide a model for comparing alternative theories and to evaluate progress across the hierarchy within a particular theory. As theories meet criteria at each step in the hierarchy, the research and applications they generate can have increasing impacts on the science and practice of health behavior change.     

Analytic attitude – focus or embodiment? Subtle communications in the transference/countertransference relationship

The paper considers a ‘befallment’ that occurred in the course of analysis at a time when the focus of work was too much at a conscious level, dissociated from the patient’s embodied and visceral depths. A rigidly held attitude of focal attention is considered as potentially a defence against embodied experiences of overwhelm and vulnerability that may haunt shadowy realms which remain unlit by the narrow beam of conscious awareness. Rather as a dream drifts in from the unconscious, an enactment by the analyst brought neglected aspects of the transference and countertransference relationship into the room. Later, the patient’s own dreaming mind offered images that suggested an underlying dynamic. These subtle communications, alongside the patient’s attitude toward the analyst’s lapse, are considered as factors in the achievement of greater embodied integration. The analyst’s difficulty in arriving at a formulation of such events is discussed, along with the necessity of holding such ‘befallments’ in mind over long periods of time before any explanation can be adumbrated.     

How Body Asymmetries Determine Accessibility in Spatial Frameworks

Spatial frameworks are a class of spatial mentalmodel that code locations of objects relative to the body axes. Spatial frameworks predict accessibility of spatial relations from memory primarily on the basis of the relative asymmetry of the body axes, such that highly asymmetric axes lead to faster retrieval of information. The present research examined how bodily asymmetries affect retrieval. Experiment 1 contrasted two theoretical accounts. The Salience Account proposes that relative degrees of asymmetry render axes differentially salient, and hence differentially foregrounded in one's mental model. The Direction Decision Account proposes that an explicit decision process is necessary to access specific locations along body axes. The ease of the decision process presumably depends on the degree of asymmetry that exists to discriminate poles along a body axis. The spatial framework pattern of accessibility was observed both when subjects identified specific directions of objects and when subjects identified just the axis to which objects were associated, supporting the Salience Account. Experiment 2 investigated whether lateralization affects accessibility from spatial frameworks. Performance of highly lateralized individuals did not differ from that of weakly lateralized individuals.