Enhancing social diffusion theory as a basis for prevention intervention: A conceptual and strategic framework

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop the conceptual and strategic (technological) bases of social diffusion theory. Within an integrative framework, we discuss in detail more effective ways to train peer mediators of behavior change as one example of how social diffusion theory can benefit from this conceptual and strategic reformulation. We then further illustrate the use of peer mediators of change in human immunodeficiency virus (HIV) and cancer prevention intervention studies with both interventions training peer mediators to diffuse information, norms, and risk reduction strategies. Although the results of these studies showed reductions in high-risk behaviors across population segments, more closely following the framework discussed in this article should further increase the behavior change potential of future interventions based on social diffusion theory.     

Regulation of hypothalamic-pituitary-adrenal activity in response to cognitive therapy in patients with generalized anxiety disorder

The aim of this study was to evaluate the efficacy of cognitive therapy (CT) in the treatment of generalized anxiety disorder (GAD), as it would be reflected through both psychological and psychoneuroendocrinological parameters. For this purpose, a group of outpatients with GAD were treated with CT for up to a maximum of 24 sessions. In order to assess psychological and biological changes, anxiety-related symptoms were evaluated according to the Hamilton Anxiety Rating Scale (HAM-A), and the hypothalamic-pituitary-adrenal (HPA) function was determined through assessment of circulating cortisol levels. A significant decrease in the HAM-A scores, along with significant changes in plasma cortisol levels, were observed after completion of treatment with CT. These observations contribute to demonstrate that the effect of certain psychotherapeutic approaches, such as CT, may be observed at both psychological and biological levels.     

Self-Determination Theory and Motivational Interviewing: Complementary Models to Elicit Voluntary Engagement by Partner-Abusive Men

Research examining intimate partner violence (IPV) has lacked a comprehensive theoretical framework for understanding and treating behavior. The authors propose two complementary models, a treatment approach (Motivational Interviewing, MI) informed by a theory (Self-Determination Theory; SDT), as a way of integrating existing knowledge and suggesting new directions in intervening early with IPV perpetrators. MI is a client-centered clinical intervention intended to assist in strengthening motivation to change and has been widely implemented in the substance abuse literature. SDT is a theory that focuses on internal versus external motivation and considers elements that impact optimal functioning and psychological well-being. These elements include psychological needs, integration of behavioral regulations, and contextual influences on motivation. Each of these aspects of SDT is described in detail and in the context of IPV etiology and intervention using motivational interviewing.     

Determinants of Relapse and the Rule Violation Effect in Predicting Safer Sex Goal Violations1

Knowledge of the determinants of lapses into unsafe sex are important parts of HIV prevention interventions. The present study examines the determinants of lapses into unsafe sex, and the role of attribution in predicting lapses into unsafe sex within an HIV prevention treatment program for homosexual men based on the relapse prevention (RP) model (Marlatt & Gordon, 1985). Self-reported negative emotional states and general urges to engage in sex were perceived to precede violations of safer sex goals. Stable and global attributions for a goal violation related to the probability of a second concurrently assessed violation. Prospective analyses indicated that future unprotected oral and anal sex was predicted by current unprotected oral and anal sex. In addition, more stable and external attributions for previous goal violations added to the prediction of future unprotected anal sex. Results are discussed in relation to the RP model, the role of attributions in safer sex goal violations, and treatments to reduce unsafe sexual behavior.     

Self-Determination Theory and Motivational Interviewing: Complementary Models to Elicit Voluntary Engagement by Partner-Abusive Men

Research examining intimate partner violence (IPV) has lacked a comprehensive theoretical framework for understanding and treating behavior. The authors propose two complementary models, a treatment approach (Motivational Interviewing, MI) informed by a theory (Self-Determination Theory; SDT), as a way of integrating existing knowledge and suggesting new directions in intervening early with IPV perpetrators. MI is a client-centered clinical intervention intended to assist in strengthening motivation to change and has been widely implemented in the substance abuse literature. SDT is a theory that focuses on internal versus external motivation and considers elements that impact optimal functioning and psychological well-being. These elements include psychological needs, integration of behavioral regulations, and contextual influences on motivation. Each of these aspects of SDT is described in detail and in the context of IPV etiology and intervention using motivational interviewing.     

Index to Volume 30

Volume Contents

Index to Volume 30     

Correlation between cortisol level and serotonin uptake in patients with chronic stress and depression

In a recent study (Tafet, Toister-Achituv, & Shinitzky, 2001), we demonstrated that cortisol induces an increase in the expression of the gene coding for the serotonin transporter, associated with a subsequent elevation in the uptake of serotonin. This stimulatory effect, produced upon incubation with cortisol in vitro, was observed in peripheral blood lymphocytes from normal subjects. In the present work we investigated the cortisol-induced increase in serotonin uptake in lymphocytes from hypercortisolemic patients, including subjects with major depressive disorder (n = 8), and subjects with generalized anxiety disorder (n = 12), in comparison with a control group of normal healthy subjects (n = 8). A significant increase in serotonin uptake (+37%+14, M + SD) was observed in the control group, whereas neither the generalized anxiety disorder nor the major depression group exhibited changes in serotonin uptake upon incubation with cortisol. It is likely that under chronic stress or depression, the capacity for increase in serotonin transporter has reached its limit due to the chronically elevated blood cortisol level. The physiological and diagnostic implications of this observation are discussed.     

Monozygotic twins with schizoform psychosis and hypothalamic-induced hypogonadotropic hypogonadism

It is reported about an uniovular male pair of twins which has been permanently hospitalized because of an intermittently progressing schizoform psychosis. A hypothalamically conditioned hypogonadotropic hypogonadism provable beyond that substantiates the possibility of the common causal genetic embodiment of both the clinical pictures which is disputed in literature.     

Youth Functioning and Experiences in Inner-City After-School Programs Among Age, Gender, and Race Groups

Many dangers and challenges face inner-city minority children during their after-school hours. Youth development programs provide an alternative to spending this time unsupervised. We examined the relationship between children's experiences in selected urban Boys and Girls Clubs and child functioning. Because the sample (N = 296) consisted of African American and Hispanic boys and girls, aged 10–18, we were able to compare these relationships across race, gender, and age groups. There was no relationship between simple participation levels and child functioning, but significant linkages were identified between specific elements of the club experience and functioning. Relationships with club staff members and participation in club activities were associated with better functioning for older boys, a subgroup that is at considerable risk for delinquency. In addition, enjoyment of the club and not feeling badly treated there were associated with better functioning for all groups of children.