The role of self-regulation strategies and self-efficacy perceptions in successful weight loss maintenance

Abstract

The purpose of this study was to identify the self-regulatory strategies which people use to lose, maintain, or manage their weight, and to assess their self-efficacy perceptions to implement these strategies. Thirty-three (N = 33) undergraduate college students were divided into three groups based on their past weight loss experience and confirmed by their current Body Mass Index: (a) overweight participants who tried but failed to lose weight, (b) participants who used to be overweight but lost significant weight and kept it off for at least six months, and (c) participants with an optimal weight. All participants were interviewed using a structured questionnaire. Data were analyzed using a one-way ANOVA and correlation analyses. Participants who used self-regulatory strategies such as goal-setting, self-monitoring, self-evaluation, environmental structuring, time management, social assistance and information seeking were better able to maintain or lose weight. Overweight participants reported significantly less strategy use than participants who had lost weight or who had a healthy weight. In addition, overweight participants had lower self-efficacy perceptions about implementing strategies than did healthy weight participants or participants who had successfully lost weight. Finally, a path analysis revealed that participants who reported high self-efficacy perceptions and applied their strategies persistently in the face of difficulties were more likely to successfully manage their weight.     

Future ethics: risk,care and non-reciprocal responsibility

As the number of intrinsically unknowable technologically produced risks global society faces continues to grow, it is evident that the question of our responsibilities towards future people is of urgent importance. However, the concepts with which this question is generally approached are, it is argued, deficient in comprehending the nature of these risks. In particular, the individualistic language of rights presents severe difficulties. An alternative understanding of responsibility is required, which, it is argued, can be developed from phenomenological and feminist concepts of care. Such concepts privilege an understanding of human beings that is primarily relational rather than individualistic, and show that responsibility is, in the first place, about connection rather than respecting separation. Care, by opening up for us an understanding of the diversity of values that are constitutive of a worthwhile life, also connects us to the future as the future of care. As such, it provides us with ethical resources that can guide us in the face of uncertainty, including general principles of action and the desire for institutions that can articulate them.     

The role of the body as the medium in child psychotherapy: snapshots of therapy with an 11-year-old,severely abused,multiply placed girl

In Victoria, Australia, children with a history of abuse and severe attachment difficulties, and who have experienced multiple carers and placements, have been traditionally viewed by mental health services as unsuitable for psychoanalytic psychotherapy. A number of factors, including the lack of integrated, long-term case planning; unstable residential placement; and the belief that psychotherapeutic treatment will be of an extended duration, have influenced the decision not to provide individual psychotherapy for these children. Currently, the movement within mental health services is towards responsive and briefer treatment models. The child psychotherapist is challenged to re-think theory, technique and practice. This paper identifies contextual constraints that have led to these children being precluded from accessing psychotherapy. An alternative model of intervention is discussed and illustrated with clinical material. The contributions of Alvarez, Trevarthen, Schore and other writers are drawn on to underpin the clinical work. This model involves a change in technique and role and the use of a time-limited intervention. Intrinsic to the model is the understanding of the child's psycho-biological experience of trauma and disrupted attachment. The child's experiences are conveyed in the pre-verbal, gestural domain to enable history to be given voice.     

Inadequate Housing Among Families Under Investigation for Child Abuse and Neglect: Prevalence from a National Probability Sample

This study aimed to estimate the prevalence of inadequate housing that threaten out-of-home placement among families under investigation by child welfare. Data came from the National Survey of Child and Adolescent Well-Being, a nationally representative longitudinal survey of child welfare-involved families. Child protective services caseworkers as well as caregivers provided information on families whose child remained in the home after initial investigation (N = 3,867). Multilevel latent class analyses tested the presence of inadequately housed subgroups using 4 housing problem indicators at baseline. Logistic regressions assessed convergent and predictive validity. A two class latent solution best fit the data. Findings indicated that inadequate housing contributed to risk for out-of-home placement in approximately 16 % of intact families under investigation by child protective services. These families were 4 times more likely to need housing services 12 months later. Federal legislation emphasizes integration of social services as necessary to end homelessness. This study demonstrates overlap across public agencies. Enhanced coordination of child welfare and housing services facilitates interventions to prevent and mitigate homelessness.     

Predictors of Diabetes Self‐care,Metabolic Control,and Mental Health in Youth with Type 1 Diabetes

The purpose of this study was to explore the psychosocial predictors of diabetes self‐care (adherence to care regimes), metabolic control (glycated haemoglobin), and mental health among rural‐ and urban‐dwelling youth with type 1 diabetes. One hundred and twenty three adolescents/young adults (aged 13?25 years, mean = 16 years, standard deviation = 3.8 years) with type 1 diabetes, 50 males and 73 females, completed questionnaires reporting on diabetes self‐care, metabolic control, mental health (negative affect, quality of life), risk‐taking behaviours and attitudes, diabetes self‐efficacy, community engagement, and perceived social support. No rural/urban differences were detected on key predictors or outcome variables. Structural equation modelling revealed that high diabetes self‐efficacy, lower risk behaviour, and more conservative attitudes to risk taking predicted better diabetes self‐care, which in turn predicted better metabolic control and mental health. Social support and engagement in community activities did not influence diabetes self‐care. The study has significance because both diabetes self‐efficacy and propensity towards risk behaviour are potential targets for educational and counselling interventions designed to improve diabetes self‐care regimes and resultant metabolic and mental health outcomes.     

Cultural Lens on Mental Illness: Four Clients Share Their Perspectives

People served by mental health providers represent diverse cultural groups. In-depth qualitative interviews were used to collect data to examine: “How do people, diagnosed with a mental illness, perceive their experience in a partial care mental health program from the perspective of their cultural context?” Four participants described cultural identities that included ethnic, health status, and sexual orientation identities. The participants' way of participating in the world was often in conflict with cultural values and expectations of the family and counselors. Cultural competence must include understanding how complex, multiple cultural contexts interact and influence a person's participation in the therapeutic process.     

Occupational Therapy Interventions for Adults at the End of Life: A Systematic Review of Dignity Therapy

The objectives of this study were to determine the effects of dignity therapy, a psychological intervention for individuals with terminal illness, and to explore whether this is an appropriate occupational therapy intervention. A literature search produced 10 dignity therapy studies for review. Four reported positive effects (decreased anxiety, depression, suffering), one reported negative effects (decreased quality of life, increased depression), and five reported no effects. With its client-centered and occupation-based approach, dignity therapy aligns with the values of occupational therapy. Practitioners should explore dignity therapy as an intervention and direct future research toward examining its efficacy as part of a holistic treatment plan.     

Reaching Out: Improving the Continuity of Care of Community Mental Health Services Through a Weekly Climbing Group

This mixed-method study examined the impact of a novel activity group on engagement in care. Thirty-two participants were recruited from National Health Service (NHS) community mental health services in three inner-London boroughs. Participants undertook eight weekly sessions of supervised climbing. There was a significant quantitative improvement in the domain “individual progress” (Z = 2.12, p = 0.03). Qualitative data indicated a wide range of benefits. The study identified both direct and indirect benefits to continuity of care. The study validates the use of a climbing activity group to engage and benefit community mental health service users.     

Psychoanalysis is becoming an impossible profession within the public welfare system in Sweden

Abstract

The preconditions for psychoanalytic practice within the Swedish public welfare system are analyzed in this article. Psychoanalysis remains a one-to-one treatment and relies on the analyst's capacity to use his or her own subjective response. The development of the psychoanalytic process is dependent on unconscious reality, making it impossible to work with a model that has a strict relation between diagnosis, treatment method, and result. Objectivity and the desire to predict treatment outcomes characterize the immanent logic in the complex system of laws and recommendations that affects most practices within the field of medicine. As a consequence of this development, psychoanalysis and psychodynamic therapy are marginalized, since our treatment methods are not adapted to the present industrialization and economization of the medical health sector, with the result that the preconditions for psychoanalytic training have changed dramatically. The exclusion of psychoanalysis from the national health insurance scheme is a demanding challenge at a time when the Swedish welfare model is undergoing fundamental changes.