Risk perceptions and participation in colorectal cancer screening

Compared individuals at high versus average risk for colorectal cancer (CRC) with respect to factors they cited as affecting their risk of developing CRC. We also examined the relationship of these risk-factor perceptions to perceived susceptibility and participation in a CRC screening test. All individuals in the high-risk group were informed that, as a sibling of someone with CRC, they were more likely to get this cancer themselves. We found minimal differences among siblings with respect to perceived susceptibility. Further, although high-risk siblings were more likely to participate in screening, only 20.2% cited heredity as a risk-increasing factor, and, among these siblings, there was no relationship between screening participation and the citation of any specific risk factors, including heredity. These findings demonstrate the need for more research examining how high-risk individuals process risk-relevant information and the effect of this information on health behavior.     

Preparing Students to Counsel Clients With Potentially Spiritually Transformative Experiences

After defining potentially spiritually transformative experiences (pSTEs) and reviewing empirical research on the contents and aftereffects of 2 well‐researched pSTEs commonly disclosed by clients, the authors summarize research on client harm due to counselors’ lack of knowledge, attitudes, and skills to address these experiences appropriately. The authors contend that clients with pSTEs meet criteria for multicultural difference and advocate for including the topic of clients with pSTEs in counselor education diversity course curricula so that counselors are empowered to provide ethical, culturally sensitive, and clinically appropriate services. The authors conclude with suggested content for this curriculum.     

Multiple causation,indirect measurement and generalizability in the social sciences

The fact that causal laws in the social sciences are most realistically expressed as both multivariate and stochastic has a number of very important implications for indirect measurement and generalizability. It becomes difficult to link theoretical definitions of general constructs in a one-to-one relationship to research operations, with the result that there is conceptual slippage in both experimental and nonexperimental research. It is argued that problems of this nature can be approached by developing specific multivariate causal models that incorporate sources of measurement bias, along with the theoretical variables of interest. Many general concepts are defined in such a way that causal assumptions are built into the definitions themselves. Additionally, in any given piece of research it is necessary to omit many variables from consideration, and this is often done without careful consideration of the assumptions required to justify such omissions. Finally, generalization to more inclusive populations or a diversity of settings ordinarily requires one to replace constants by variables. It is concluded that the criteria of parsimony, generalizability, and precision are incompatible, given the multivariate nature of social causation, and the author expresses his own preference for sacrificing parsimony in favor of the objectives of achieving increased precision and generalizability of social science laws.     

Illness attributions and hopelessness depression: the role of hopelessness expectancy.

According to hopelessness theory, hopelessness expectancy is the proximal, sufficient cause of hopelessness depression. Consequently, hopelessness expectancy is viewed as mediating the influence of all other factors on hopelessness depression. Using a longitudinal research design, we examined hopelessness expectancy as a mediator of the relation between illness attributions and hopelessness depression in a sample of 57 adults with rheumatoid arthritis. Although hopelessness expectancy was a strong predictor of hopelessness depression, it moderated rather than mediated the relation between attributions and depression. Finding support for a moderating rather than a mediating model is inconsistent with theory but is consistent with the findings of Riskind, Rholes, Brannon, and Burdick (1987).     

The role of background knowledge in speeded perceptual categorization

We examined the time-course of the influence of background knowledge on perceptual categorization by manipulating the meaningfulness of labels associated with categories and by manipulating the amount of time provided to subjects for making a categorization decision. Extending a paradigm originally reported by Wisniewski and Medin (1994) (Cog. Sci. 18 (1994) 221), subjects learned two categories of children's drawings that were given either meaningless labels (drawings by children from 'group 1' or 'group 2') or meaningful labels (drawings by 'creative' or 'non-creative' children); the meaningfulness of the label had a significant effect on how new drawings were classified. In addition, half of the subjects were provided unlimited time to respond, while the other half of the subjects were forced to respond quickly; speeded response conditions had a relatively large effect on categorization decisions by subjects given the meaningless labels but had relatively little effect on categorization decisions by subjects given the meaningful labels. These results suggest that some forms of background knowledge can show an influence at relatively early stages in the time-course of a categorization decision.     

Preliminary examination of sex differences in depressive symptoms among adolescent psychiatric inpatients: the role of anxious symptoms and generalized negative affect.

Assessed the emerging view that generalized negative affect and anxious symptoms are important in understanding sex differences in depressive symptoms. Sixty-three adolescent psychiatric inpatients (32 boys, 31 girls), ages 12 to 16 (M = 13.87, SD = 1.36), completed measures of positive and negative affect and anxious and depressive symptoms. Results demonstrated, as predicted, that depressive and anxious symptoms were more highly associated in adolescent girls than boys. Furthermore, girls with depressive symptoms were more likely to have comorbid anxious symptoms than boys with depressive symptoms. Sex differences were not found for adolescents with specific depressive symptoms and specific anxious symptoms (i.e., the absence of comorbidity). Our findings supported the possibility that sex differences in pure forms of depression are overestimated and that comorbid internalizing conditions may be more prevalent in adolescent girls than boys.     

The relationship of childhood trauma to nicotine dependence in pregnant smokers

Pregnant women with high levels of nicotine dependence are the least likely to quit smoking spontaneously during pregnancy or to benefit from smoking cessation interventions. In the general population, there is increasing evidence of a relationship between smoking, nicotine dependence, and exposure to childhood trauma. We examined the relationship of childhood trauma to several measures of nicotine dependence and evaluated whether this relationship was mediated by major depressive disorder or depressive symptom severity in pregnant smokers. Moderate to extreme levels of childhood trauma were significantly related to smoking within 5 minutes or less of waking, and to the Behavioral Choice-Melioration, Negative Reinforcement, and Tolerance subscales of the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68) scale. The relationships between childhood emotional abuse and the WISDM-68 Total and Negative Reinforcement subscale were partially mediated by depressive symptoms. Results suggest that childhood trauma may be a risk factor underlying nicotine dependence in pregnant smokers. Increased understanding of the relationship of affect regulation to smoking in individuals with childhood trauma histories may aid in the development of more effective treatments of nicotine dependence for this population of smokers.     

Gender differences in depression: The role of anxiety and generalized negative affect

This study used the tripartite model of depression and anxiety to examine whether gender differences in depression may be accounted for, in part, by the overlap of depression with anxiety and negative affectivity. The tripartite model distinguishes between pure forms of depression and anxiety, co-morbid depression and anxiety, and mixed anxiety-depression. One hundred-six college students completed questionnaires that measured depression, anxiety, and negative and positive affectivity. Results were moderately consistent with hypotheses. Specifically, the proportion of women versus men was significantly higher in the categories of co-morbid depression and anxiety and mixed anxiety-depression, but not in the categories of specific (i.e., pure) depression or anxiety. It is argued that specific depression may be equally prevalent in men and women, but that other depression-related syndromes may be more common among women than men.     

Predicting Participation in Cancer Screening: The Role of Perceived Behavioral Control1

We examined the role played by perceived behavioral control in predicting participation in colorectal cancer screening among individuals recently informed that they were at high risk for this type of cancer. A telephone interview based primarily on the theory of reasoned action was administered to 96 high-risk individuals and 144 average-risk individuals. All participants then were sent materials needed to complete the screening test. In both groups, perceived behavioral control enhanced prediction of intention to complete the test over and above the contributions of attitude and subjective norm. In addition, perceived behavioral control had a direct effect on behavior but only in the high-risk group. Further, for high-risk subjects, knowledge about test procedures moderated the relationship of perceived behavioral control and intention to behavior, but in ways only partially consistent with theory. Finally, the model was better at predicting behavior in the average than in the high-risk group. We conclude that perceived behavioral control plays an important role in the prediction of screening behavior. Perceived behavioral control's motivational role manifests itself unambiguously through its influence on intention. The role of perceived behavioral control above and beyond its influence on intention, however, needs further study and clarification.     

Social Comparison Among Individuals With Rheumatoid Arthritis1

This study examined the types of social comparisons made by individuals with rheumatoid arthritis (RA) and the role these comparisons play in illness adjustment. Seventy-five women with RA were interviewed. The interview included measures of social comparison preferences assessed within two different contexts: the establishment of standards for desired performance and the experience of performance difficulties. Perceived ability, satisfaction with ability, and psychological adjustment also were assessed. We found that when respondents were experiencing performance difficulties they compared more frequently with other RA patients than with individuals not affected by RA. However, when establishing standards for desired performance, the latter type of comparison was more common. Further, respondents' comparison preferences were not related to perceptions of ability, but were related to satisfaction with ability. Greater satisfaction was associated with comparison with individuals not affected by RA when establishing standards for desired performance and comparison with other RA patients when experiencing performance difficulties. Satisfaction, in turn, was positively related to psychological adjustment.