What do people think about changes in health behaviors? Differential perceptions of consequences of increases and decreases in health behaviors

Most health decision-making models posit that cost-benefit analyses underlie decisions to make changes in health-related behavioral practices. In a series of studies, participants imagined either increasing or decreasing the frequency of a variety of health behaviors and estimated the consequences of those changes. In Studies 1 and 2, individuals consistently estimated that increasing a health behavior produced greater consequences than did decreasing the behavior by an equivalent amount. The results of Study 3 demonstrated that this effect is due to differences in how individuals judge the impact of health behavior changes which involve not engaging in the behavior at all versus other types of changes. Taken together, these findings suggest that perceptions of the outcomes afforded by health behavior changes depend on both the behavioral frequency and direction of changes in behavior an individual is considering. This asymmetry has the potential to help explain patterns of behavior in a range of important health domains and may impact the effectiveness of behavior change interventions.     

Interpreting cross-sectional data on stages of change

Abstract

The vast majority of studies investigating stage theories of health behaviour such as the transtheoretical model have used a cross-sectional research design. Participants are classified into stages and compared on theoretically relevant variables. This paper discusses the proper interpretation of cross-sectional data on stages of change. Linear patterns are not consistent with the stage model assumption that different causal factors are important at different stages but discontinuity patterns (patterns that do not show consistent increments or decrements across stages) can be diagnostic of a stage model. Researchers who use cross-sectional designs should specify predictions concerning the patterns to be expected under a stage model and under possible rival models, and interpret their data accordingly. Wherever possible, they should conduct prospective longitudinal and experimental studies which enable stronger inferences to be drawn.     

‘Them’ and ‘us’: The experiences of women with metastatic disease in mixed-stage versus stage-specific breast cancer support groups

The objective of this study was to explore the experiences of women with metastatic breast cancer (MBC) in mixed-stage and stage-specific groups. Interpretative phenomenological analysis (IPA) was used to examine 15 interviews from eight women with MBC. The interviewees felt that their experiences were very much different from those of women with primary breast cancer (BC), because of their different prognoses. In mixed-stage groups, the interviewees described feeling silenced, marginalised and helpless. They did not receive support in these groups because survivors of primary BC are often afraid to face the idea of metastasis. In stage-specific MBC groups, on the other hand, women were able to talk openly and were understood by others with whom they identified. They became more informed about issues related to their illness. Seeing others living well despite MBC made them feel more hopeful. Although there are some disadvantages of participating in stage-specific groups, the findings suggest that, overall, stage-specific groups are more helpful to women with MBC than mixed-stage groups. These findings have implications for the provision of group support for this population.     

Counter-Closure

The focus of this paper is the prima facie plausible view, expressed by the principle of Counter-Closure, that knowledge-yielding competent deductive inference must issue from known premises. I construct a case that arguably falsifies this principle and consider five available lines of response that might help retain Counter-Closure. I argue that three are problematic. Of the two remaining lines of response, the first relies on non-universal intuitions and forces one to view the case I construct as exhibiting a justified, true belief to which none of the usual diagnoses of knowledge failure in Gettier cases apply. The second line involves claiming that Fake Barns and its ilk are misdiagnosed by epistemological orthodoxy as Gettier cases. We are thus confronted by a trilemma: either the case I discuss undermines the first-blush plausible principle of Counter-Closure; or the case I discuss instantiates a novel kind of Gettier case; or a popular conception of a key range of alleged Gettier cases must be rejected. No matter which horn we choose, the case points to a philosophically curious conclusion.     

Physicians' Silent Decisions: Because Patient Autonomy Does Not Always Come First

Physicians make some medical decisions without disclosure to their patients. Nondisclosure is possible because these are silent decisions to refrain from screening, diagnostic or therapeutic interventions. Nondisclosure is ethically permissible when the usual presumption that the patient should be involved in decisions is defeated by considerations of clinical utility or patient emotional and physical well-being. Some silent decisions—not all—are ethically justified by this standard. Justified silent decisions are typically dependent on the physician's professional judgment, experience and knowledge, and are not likely to be changed by patient preferences. We condemn the inappropriate exclusion of the patient from the decision-making process. However, if a test or treatment is unlikely to yield a net benefit, disclosure and discussion are at times unnecessary. Appropriate silent decisions are ethically justified by such considerations as patient benefit or economy of time.     

Coping mediates between social support,neuroticism, and depression after earthquake and examination stress among adolescents

Abstract

The objective of this study was to investigate the mediating role of coping strategies in the relationships between neuroticism, social support, and depression in two groups of adolescents: earthquake group and examination group. Adolescents facing earthquake stress (earthquake group, N=219) completed measures of neuroticism, perceived social support, coping strategies, and self-rating depression. Similarly, adolescents facing examination stress (examination group, N=241) completed the same measures. Results indicated that the earthquake group reported more use of secondary control engagement coping, whereas the examination group reported more use of primary control engagement coping. In addition, neuroticism was more strongly associated with coping in earthquake group and coping strategies explained significantly larger part of the relationship between neuroticism and depression. In contrary, perceived social support was more strongly associated with coping in examination group, and coping strategies explained significantly larger part of the relationship between perceived social support and depression.     

Experimentally testing Taylor's stress,coping and adaptation framework

Abstract

Taylor (1995) constructed a comprehensive framework of stress and adaptation, which considers internal and external resources/impediments as moderators, based on previous studies and models. However, most past research used correlation designs and has not taken into account all of the framework's components within one study. This study tested the effects of the event (minor, major), primary appraisal (benign, severe), coping (problem-focused coping (PFC) versus emotion-focused coping), external resources (with/without social support), and internal impediments (hostility), on estimated distress (dependent variable) in written imagined stressful daily scenarios. All components except hostility were experimentally manipulated within subjects in the scenarios. The scenarios were rated by 281 Dutch students. The variables event, appraisal, and social support significantly and independently affected estimated distress. Event and appraisal synergistically interacted in relation to estimated distress. Finally, appraisal interacted with coping such that the distress-reducing effects of PFC occurred only in benign events, while coping did not affect estimated distress in severely appraised events. This study experimentally tested most components of Taylor's framework, and showed that events, appraisal, and social resources were independent determinants of estimated distress, and that appraisal interacts in a complex manner with the event and with coping.     

Belief–logic conflict resolution in syllogistic reasoning: Inspection-time evidence for a parallel-process model

An experiment is reported examining dual-process models of belief bias in syllogistic reasoning using a problem complexity manipulation and an inspection-time method to monitor processing latencies for premises and conclusions. Endorsement rates indicated increased belief bias on complex problems, a finding that runs counter to the “belief-first” selective scrutiny model, but which is consistent with other theories, including “reasoning-first” and “parallel-process” models. Inspection-time data revealed a number of effects that, again, arbitrated against the selective scrutiny model. The most striking inspection-time result was an interaction between logic and belief on premise-processing times, whereby belief – logic conflict problems promoted increased latencies relative to non-conflict problems. This finding challenges belief-first and reasoning-first models, but is directly predicted by parallel-process models, which assume that the outputs of simultaneous heuristic and analytic processing streams lead to an awareness of belief – logic conflicts than then require time-consuming resolution.