An experimental test to reveal negative side-effects of high treatability information on preventative health behaviour

Objectives: When the course of a disease can be positively changed by health professionals the disease can be indicated as ‘highly treatable’. This ‘high treatability information’ (HTI) may have negative side-effects on people’s preventative motivation. This study examined the effects of HTI regarding skin cancer on preventative motivation.

Design: This study employed a 2 (high treatability (HTI) versus low treatability (LTI)) × 2 (high versus low susceptibility)?experiment with a hanging control group. (family) History and self-efficacy were assessed as moderators. Participants (N = 309) were randomly assigned to one of the five conditions.

Main outcome measures: The main outcome was intention to engage in preventative actions regarding skin cancer.

Results: HTI significantly lowered the intention compared to LTI, under the condition of high susceptibility in people with low self-efficacy. In addition, in people with a (family) history of skin cancer, HTI significantly lowered the intention compared to the no-information group.

Conclusion: HTI regarding skin cancer can cause a drop in the preventative motivation. The effects can be conceptualised as negative side-effects of HTI. As substantial proportions of the general population have a (family) history of skin cancer or low self-efficacy, the side-effects may be widespread, possibly increasing the incidence of skin cancer.     

Emotional processes in risky and multiattribute health decisions

Objective: Here, we develop an integrative account of the roles of emotion in decision-making. In Part I, we illustrate how emotional inputs into decisions may rely on physiological signals from emotions experienced while making the decision, and we review evidence suggesting that the failure to represent the emotional meaning of options can often reduce decision quality. We propose that health-related decrements in the ability to generate emotional reactions lead people to inaccurately represent emotional responses and compromise decisions, particularly about risk. Part II explores complex decisions in which choice options involve trade-offs between positive and negative attributes. We first review evidence showing that difficult trade-off decisions generate negative affect and physiological arousal. Next, we propose that medical decision-making will be linked to short- and long-term stress and health outcomes.

Conclusion: In sum, this article proposes and reviews initial evidence supporting the effective use and management of emotional inputs as important to both clinical and non-clinical populations. Our approach will contribute to the understanding of patient-centred emotional decision-making and will inform medical decision aids.     

Understanding the prevalence and correlates of implicit theories of weight in the United States: Insights from a nationally representative sample

Objectives: The primary aim of this research is to understand how mindsets about weight controllability in the United States relate to population health. We examined the distribution of people’s implicit theories of weight, from an incremental (controllable) to an entity (not controllable) mindset, in a nationally representative sample, as well as their relation to: sociodemographic factors, beliefs about behaviour and genetics as causes of obesity and engagement in weight management-relevant behaviours.

Methods: We report data from the National Cancer Institute’s Health Information National Trends Survey 4.

Results: A majority of respondents endorsed an incremental mindset of body weight, but endorsement of this mindset was stronger among younger, white respondents, and those with a higher income and more educational attainment. A stronger incremental mindset was related to stronger behaviour and weaker genetic causal beliefs about obesity, as well as a tendency to report increased engagement in weight management-relevant behaviours.

Conclusions: Our research provides evidence that although incremental mindsets are more common overall and associated with engagement in health behaviours that can contribute to or detract from population health, incremental mindsets are less common among individuals from more marginalised groups.     

Letting Go: Conceptualizing Intervention De‐implementation in Public Health and Social Service Settings

The discontinuation of interventions that should be stopped, or de‐implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de‐implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de‐implemented. We identify three criteria for identifying interventions appropriate for de‐implementation: (a) interventions that are not effective or harmful, (b) interventions that are not the most effective or efficient to provide, and (c) interventions that are no longer necessary. Detailed, well‐documented examples illustrate each of the criteria. We describe de‐implementation frameworks, but also demonstrate how other existing implementation frameworks might be applied to de‐implementation research as a supplement. Finally, we conclude with a discussion of de‐implementation in the context of other stages of implementation, like sustainability and adoption; next steps for de‐implementation research, especially identifying interventions appropriate for de‐implementation in a systematic manner; and highlight special ethical considerations to advance the field of de‐implementation research.     

Naturally Occurring Mentorship in a National Sample of First‐Generation College Goers: A Promising Portal for Academic and Developmental Success

Attending college is increasingly important to compete in this global world; however, young people whose parents did not attend college are significantly less likely to enroll in and finish college. Formal programs to support first‐generation college goers are common, but not scalable to provide support to all young people who need it. Instead, mentoring that naturally occurs on these students’ journeys into and out of college may be a more practical avenue for supporting their success. This study investigated the role community members, relatives, and educators play in first‐generation college goers’ educational outcomes. Data from 4,181 participants of the National Longitudinal Study of Adolescent and Adult Health were used to test differences in supports received between first‐generation, continuing‐generation, and non‐college goers. Results demonstrated that mentorship in adolescence moderated the relationship between parental college attendance and educational attainment in adulthood. Next, findings suggested that first‐generation students received less support for identity development from their mentors than continuing‐generation students. This study has program implications for facilitating college attendance and fostering the development and success of first‐generation students. Moreover, this project continues to concretize an emerging taxonomy of mentoring functions for youth and emerging adults.     

A force of change: Chris Peterson and the US Army’s Global Assessment Tool

The US Army launched the Global Assessment Tool (GAT) – a 105-item psychometric instrument taken by approximately one million soldiers annually – in October, 2009 in support of a population-wide resilience development initiative known as the Comprehensive Soldier and Family Fitness (CSF2) program. The lead developer of the GAT was Chris Peterson, and his work on this project – along with that of Nansook Park and Colonel Carl Castro – will likely leave an important and indelible mark on not only the Army, but also the field of military psychology. In this paper, we provide more detail on the history and components of the GAT. In addition, we demonstrate the practical utility of the GAT by showing that high-performing soldiers (soldiers who attained Ranger status) have relatively high GAT scores, and that soldiers with behavioral problems generally evidence low GAT scores. We conclude by discussing future directions of GAT methodology and usage in support of research.     

Changes in schemas of patients with severe borderline personality disorder: The Oulu BPD study

Borderline personality disorder (BPD) is a relatively common and severe psychiatric disorder that can impair quality of life in many ways. The aim of this study was to determine whether a combined treatment model for BPD patients, utilising major principles from schema‐focused therapy (SFT) and dialectical behavioral therapy (DBT), could be more effective in relieving early maladaptive schemas of BPD patients, compared to treatment as usual (TAU). This study is a part of the Oulu BPD study conducted at mental health care services run by Oulu city social and health care services. The study is a multisite, randomized controlled trial conducted over a one year period, involving two groups of patients with severe BPD: (1) Community Treatment By Experts (CTBE) patients (n = 18) receiving the combined treatment model, and 2) TAU patients (n = 27). The patients' schemas were assessed using the Young Schema Questionnaire (YSQ‐L3a) before and after one year of treatment. The results reveal that CTBE patients who attended the combined treatment model showed a statistically significant reduction in eight out of 18 early maladaptive schemas, while patients receiving treatment as usual did not demonstrate any significant changes in schemas. The cognitive therapeutic treatment model can be applied for clinical use in public mental health settings using existing professionals, and appears to produce positive changes in patients with BPD.     

Vocational Personality Traits in Counselor Education and School Psychology Students

We assessed the vocational personality of 104 graduate students in school counseling, mental health counseling, and school psychology programs using Holland's ( 1997 ) theory of personality and career choice. The correlational findings confirmed the importance of vocational personality traits in relation to the academic performance of graduate students. Among the Self‐Directed Search–Revised vocational personality types, the Investigative type emerged as a consistent predictor of performance on all sections of the Graduate Record Examination. The participants from 3 graduate programs predominantly identified Social as their primary vocational personality type, with variability in the secondary and tertiary code positions. The student group with the highest degree of congruence, defined as the degree of fit between one's personality and the environment, had the highest graduate grade point average, indicating the relationship between the degree of congruence and achievement. Theoretical and practical implications of the findings are discussed.     

Mental Health Utilization Among Diverse Parenting Young Couples

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social–personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor–Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow‐up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse’s influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.