Regulatory focus and adherence to self-care behaviors among adults with type 2 diabetes

The aims of this study were, first, to test the association between regulatory focus of adults with type 2 diabetes and their adherence to two types of self-care behaviors – lifestyle change (e.g. physical activity and diet) and medical care regimens (blood-glucose monitoring, foot care and medication usage). Second, to explore whether a fit between the message framing and patients’ regulatory focus would improve their intentions to adhere specifically when the type of behavior fits the patients’ regulatory focus as well. A cross-sectional study was conducted among 130 adults with type 2 diabetes who were hospitalized in an academic medical center. The patients completed a set of questionnaires that included their diabetes self-care activities, regulatory focus, self-esteem and demographic, socioeconomic and clinical data. In addition, participants were exposed to either a gain-framed or a loss-framed message, and were then asked to indicate their intention to improve adherence to self-care behaviors. A multivariable linear regression model revealed that promoters reported higher adherence to lifestyle change behaviors than preventers did (B = .60, p = .028). However, no effect of regulatory focus on adherence to medical care regimens was found (B = .46, p = .114). In addition, preventers reported higher intentions to adhere to medical care behaviors when the message framing was congruent with prevention focus (B = 1.16, p = .023). However, promoters did not report higher intentions to adhere to lifestyle behaviors when the message framing was congruent with promotion focus (B = ?.16, p = .765). These findings justify the need to develop tailor-made interventions that are adjusted to both patients’ regulatory focus and type of health behavior.     

Perceived threat and depression among patients with cancer: the moderating role of health locus of control

Illness perception was found to be a better predictor of psychological outcome among cancer patients than the objective characteristics of illness. The current study explored the association between the perceived threat of illness (a major aspect of illness perception) and depression among cancer patients. We examined the hypothesis that this association will be higher for persons with low External (others) or internal (self) Health Locus of Control (HLC) than for those with high HLC. The study took an exploratory approach regarding the role that different sources of control (external and internal) may assume. Fifty-seven cancer patients completed self-report measures of Perceived Life Threat (PLT), HLC and Depression. The possible moderating role of HLC on the relationship between PLT and Depression was examined. A significant relationship between perceived threat and depression was found only among participants reporting low levels of internal locus of control. The results support the hypothesis that perception of cancer as life threatening is important factor in determining the level of depression among cancer patients. The results also support the differentiation between internal and external HLC and suggest that internal HLC may be more relevant than external HLC in managing perceived threat. Internal locus of control can be interpreted as having a sense of agency and mastery which is important in managing the cognitive perception of the threat of illness. Further research is needed in order to determine the role of external HLC in managing perceived or actual threats.     

Associations between multiple health risk behaviors and mental health among Chinese college students

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95%CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.     

How religiosity shapes health perceptions and behaviors of Latina immigrants: is it an enabling or prohibitive factor?

The study examines how religiosity shapes the health perceptions and health-related behaviors of 50 Latina immigrants from El Salvador, Guatemala, Mexico and Bolivia. Between May and August 2011, focus groups were conducted with participants representing each country of origin. Qualitative content analysis was the analytic strategy adopted in the study. The meta-theme, Religiosity Contributes to Positive Perceptions of Health and Health-Promoting Behaviors, is associated with six emerging themes: (1) Religiosity promotes a sense of personal responsibility for one’s health; (2) Religiosity promotes a holistic view of health; (3) Religiosity promotes the view that health is a priority; (4) Religiosity promotes the view that health enables one to perform necessary tasks; (5) Religiosity promotes health-seeking behavior; and (6) Religiosity provides intrinsic health benefits. Findings do not follow the clear-cut dichotomy of the health locus of control model and challenge simplified notions that Latinas hold a purely external health locus of control toward their health and health care. Latinas rely on both God and themselves in managing their health and engaging in health-promoting actions, which are prompted in large part by their religiosity. Implications for culturally appropriate health communication and interventions are discussed.     

Mental health disparities impacting Christian Korean Americans: a qualitative examination of pastors’ perspectives

Mental health disparities impacting Korean Americans are multifaceted. Although encouraging developments have been made in the knowledge of mental health prevalence and professional help-seeking behaviours of Asian Americans, Korean Americans continue to experience many challenges and unique needs that require more ethnic- and culture-specific knowledge. Given the prominent role that religion, particularly Christianity, plays in the Korean American context, we conducted exploratory interviews with 10 Korean American pastors regarding their perspectives on mental health issues impacting the Korean American community. Using consensual qualitative research, we found four salient domains: (a) Barriers to seeking mental health services, (b) Challenges that pastors experience, (c) Pastor’s assessment of church’s current climate in approaches to mental health issues, and (d) What is needed. Implications for research and practice in addressing mental health disparities are discussed.     

Are you ‘woman enough’ to control your leading cause of death?: an ethnographic content analysis of women’s cardiovascular disease and identities in media narratives

The Heart Truth^® campaign was implemented in the United States by the National Heart, Lung, and Blood Institute in 2002 to increase women’s awareness of heart disease and encourage risk reduction of cardiovascular disease. The present study explored representations of women’s cardiovascular disease, the meanings generated, and the implications for identity construction within one prominent corporate media partner of the campaign. The inaugural 2003 October issue of Glamour magazine was the focus of an ethnographic content analysis. Women’s cardiovascular disease was constructed within an overarching theme of a culture of consumerism, with meanings of cardiovascular disease emerging within two subthemes: (a) the oblivious, unknowledgeable, dependent woman at risk and (b) attaining a particular version of a healthy, feminine woman. Women’s identities were constructed as dependent on experts, purchasing fashion and fitness merchandise, and heteronormative roles for health management. These findings extend health psychology research that has called for more critical explorations of media to extend understandings of disease meanings and the implications for identity and women’s health.     

Beyond the Tremors: What Counselors Should Know About the Mental Health Needs of Clients Diagnosed With Parkinson's Disease

Parkinson's disease (PD) is the 2nd most common neurodegenerative disorder, affecting 1% to 4% of people by age 80 (Black, 2011 ). However, co‐occurring psychological disorders, such as depression, anxiety, and apathy, are significantly underdiagnosed. Professional counselors are uniquely qualified to assist clients with these mental health complications of PD.     

Adult Missing Persons: Can an Investigative Framework be Generated Using Behavioural Themes?

There is a limited amount of research in the area of missing persons, especially adults. The aim of this research is to expand on the understanding of missing people, by examining adults' behaviours while missing and determining if distinct behavioural themes exist. Based on previous literature it was hypothesised that three behavioural themes will be present; dysfunctional, escape, and unintentional. Thirty‐six behaviours were coded from 362 missing person police reports and analysed using smallest space analysis (SSA). This produced a spatial representation of the behaviours, showing three distinct behavioural themes. Seventy percent of the adult missing person reports were classified under one dominant theme, 41% were ‘unintentional’, 18% were ‘dysfunctional’, and 11% were ‘escape’. The relationship between a missing person's dominant behavioural theme and their assigned risk level and demographic characteristics were also analysed. A significant association was found between the age, occupational status, whether they had any mental health issues, and the risk level assigned to the missing person; and their dominant behavioural theme. The findings are the first step in the development of a standardised checklist for a missing person investigation. This has implications on how practitioners prioritise missing adults, and interventions to prevent individuals from going missing. Copyright © 2016 John Wiley & Sons, Ltd.     

Early and Late Life Exposure to Trauma and Biopsychosocial Well-Being in Centenarians

Few studies have investigated the proximal versus distal influence of traumatic life events (TLE) on biopsychosocial resources of very old adults. The Developmental Adaptation Model was used to test TLE experienced before and after the age of 60 on outcomes of centenarians’ physical disability, perceived health impairments, depressive symptoms, and social support. Cross-sectional data were collected from 154 community-dwelling centenarians. Results indicated that TLE in the latter half of life were positively associated with health impairments and depressive symptoms. The present results emphasize the importance of a process-oriented approach to resilience that allows flexibility in successful coping across the lifespan.     

Frequency and impact of trauma in older women: A military and nonmilitary sample

Understanding the impact of trauma on late-life functioning in older females is needed in order to provide best care. We explored the impact of trauma on late-life psychological and physical health and functioning among older women (n = 48) who served in the military, or participated in a military lifestyle. Eleven of these women were not veterans, but married to military personnel. Number of traumatic exposures and types of events experienced was associated with increased trauma symptom severity. Trauma symptom severity was associated with decreased physical functioning and increased pain. Increased numbing and avoidance was significantly associated with poorer physical functioning and increased pain. Older women in this study remained at risk of experiencing negative consequences of trauma in terms of increased quantity and severity of trauma symptoms and physical decline and pain. Clinical and research implications are discussed.