Health-compromising behaviors such as physical inactivity and poor dietary habits are difficult to change. Most social-cognitive theories assume that an individual’s intention to change is the best direct predictor of actual change. But people often do not behave in accordance with their intentions. This discrepancy between intention and behavior is due to several reasons. For example, unforeseen barriers could emerge, or people might give in to temptations. Therefore, intention needs to be supplemented by other, more proximal factors that might compromise or facilitate the translation of intentions into action. Some of these postintentional factors have been identified, such as perceived self-efficacy and strategic planning. They help to bridge the intention– behavior gap. The Health Action Process Approach (HAPA) suggests a distinction between (a) preintentional motivation processes that lead to a behavioral intention, and (b) postintentional volition processes that lead to the actual health behavior. In this article, seven studies are reported that examine the role of volitional mediators in the initiation and adherence to five health behaviors: physical exercise, breast self-examination, seat belt use, dietary behaviors, and dental flossing. The general aim is to examine the applicability of the HAPA and its universality by replicating it across different health behaviors, based on various measures, time spans, and samples from different countries. Les comportements nuisibles a la sante tels que le manque d’exercice physique et les mauvaises habitudes alimentaires sont difficiles a modifier. La plupart des theories socio-cognitives admettent que le meilleur predicteur d’un reel changement est l’intention que la personne a de changer. Mais la conduite est souvent en contradiction avec les intentions. La divergence entre intention et comportement est due a plusieurs raisons. Par exemple, des obstacles imprevus

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Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors

ガイドライン解説 AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease : 2011 update

Objective: The present article presents an overview of theoretical constructs and mechanisms of health behavior change that have been found useful in research on people with chronic illness and disability. A self-regulation framework (Health Action Process Approach) serves as a backdrop, making a distinction between goal setting and goal pursuit. Risk perception, outcome expectancies, and task self-efficacy are seen as predisposing factors in the goal-setting (motivational) phase, whereas planning, action control, and maintenance/recovery self-efficacy are regarded as being influential in the subsequent goal-pursuit (volitional) phase. The first phase leads to forming an intention, and the second to actual behavior change. Such a mediator model serves to explain social– cognitive processes in health behavior change. By adding a second layer, a moderator model is provided in which three stages are distinguished to segment the audience for tailored interventions. Identifying persons as preintenders, intenders, or actors offers an opportunity to match theorybased treatments to specific target groups. Numerous research and assessment examples, especially within the physical activity domain, serve to illustrate the application of the model to rehabilitation settings and health promotion for people with chronic illness or disability. Conclusions/Implications: The theoretical developments and research evidence for the self-regulation framework explain the cognitive mechanisms of behavior change and adherence to treatment in the rehabilitation setting.

Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA).

A family of detoxifying enzymes called aldehyde dehydrogenases (ALDHs) has been a subject of recent interest, as its role in detoxifying aldehydes that accumulate through metabolism and to which we are exposed from the environment has been elucidated. Although the human genome has 19 ALDH genes, one ALDH emerges as a particularly important enzyme in a variety of human pathologies. This ALDH, ALDH2, is located in the mitochondrial matrix with much known about its role in ethanol metabolism. Less known is a new body of research to be discussed in this review, suggesting that ALDH2 dysfunction may contribute to a variety of human diseases including cardiovascular diseases, diabetes, neurodegenerative diseases, stroke, and cancer. Recent studies suggest that ALDH2 dysfunction is also associated with Fanconi anemia, pain, osteoporosis, and the process of aging. Furthermore, an ALDH2 inactivating mutation (termed ALDH2*2) is the most common single point mutation in humans, and epidemiological studies suggest a correlation between this inactivating mutation and increased propensity for common human pathologies. These data together with studies in animal models and the use of new pharmacological tools that activate ALDH2 depict a new picture related to ALDH2 as a critical health-promoting enzyme.

Targeting aldehyde dehydrogenase 2: new therapeutic opportunities

Do implementation intentions help to eat a healthy diet? A systematic review and meta-analysis of the empirical evidence

Background: Eating a diet that is high in vitamins and low in fat is considered to be governed by social-cognitive factors, such as intentions, planning, self-efficacy, and outcome expectancies. Purpose: A longitudinal field study was designed to examine the interrelationships of these factors with dietary behaviors. Method: In 697 South Korean men and women, objective health-risk status was assessed at Time 1 (cholesterol, blood pressure, and body mass index) in conjunction with self-efficacy, outcome expectancies, and intentions. At Time 2, six months later, coping self-efficacy, planning, and dietary behaviors were measured. A two-group structural equation model for men and women was specified to determine the relations of distal and proximal predictors of a healthy diet. Results: Self-efficacy was of equal predictive power in men and women, whereas intentions and planning were relevant only in women. Objective risk status was associated with intentions in women but not in men. Conclusions: Results confirm the predictive power of the Health Action Process Approach and point to the role of gender in the self-regulation of dietary behaviors.

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Social-cognitive predictors of dietary behaviors in South Korean men and women.

For a long time, alcohol was thought to exert a general depressant effect on the central nervous system (CNS). However, currently the consensus is that specific regions of the brain are selectively vulnerable to the acute effects of alcohol. An alcohol-induced blackout is the classic example; the subject is temporarily unable to form new long-term memories while relatively maintaining other skills such as talking or even driving. A recent study showed that alcohol can cause retrograde memory impairment, that is, blackouts due to retrieval impairments as well as those due to deficits in encoding. Alcoholic blackouts may be complete (en bloc) or partial (fragmentary) depending on severity of memory impairment. In fragmentary blackouts, cueing often aids recall. Memory impairment during acute intoxication involves dysfunction of episodic memory, a type of memory encoded with spatial and social context. Recent studies have shown that there are multiple memory systems supported by discrete brain regions, and the acute effects of alcohol on learning and memory may result from alteration of the hippocampus and related structures on a cellular level. A rapid increase in blood alcohol concentration (BAC) is most consistently associated with the likelihood of a blackout. However, not all subjects experience blackouts, implying that genetic factors play a role in determining CNS vulnerability to the effects of alcohol. This factor may predispose an individual to alcoholism, as altered memory function during intoxication may affect an individual’s alcohol expectancy; one may perceive positive aspects of intoxication while unintentionally ignoring the negative aspects. Extensive research on memory and learning as well as findings related to the acute effects of alcohol on the brain may elucidate the mechanisms and impact associated with the alcohol-induced blackout.

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Alcohol-induced blackout.

The effects of a virtual reality treatment program for online gaming addiction

Aim
We compared the efficacy of bupropion and escitalopram treatments in Internet gaming disorder (IGD) patients.

Methods
We recruited 119 adolescents and adults with IGD. We treated these participants for 6 weeks in three groups as follows: 44 participants were treated with bupropion SR (bupropion group), 42 participants were treated with escitalopram (escitalopram group), and 33 patients without any medication were observed in the community (observation group). At baseline and at the 6-week follow-up visit, all subjects were evaluated using the Clinical Global Impression-Severity Scale, the Young Internet Addiction Scale, the Beck Depression Inventory, the ADHD Rating Scale, and the Behavioral Inhibition and Activation Scales.

Results
Both the escitalopram group and the bupropion group showed improvement on all clinical symptom scales after 6 weeks of treatment compared to the observation group. Additionally, the bupropion group showed greater improvement on scores for the Clinical Global Impression-Severity Scale, the Young Internet Addiction Scale, the ADHD Rating Scale, and the Behavioral Inhibition Scale than the escitalopram group.

Conclusion
Both bupropion and escitalopram were effective in treating and managing IGD symptoms. Moreover, bupropion appeared to be more effective than escitalopram in improving attention and impulsivity in IGD patients. In addition, attention and impulsivity seem to be important for the management of IGD.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/pcn.12429

Sungwon Roh

Papers

Social-cognitive predictors of dietary behaviors in South Korean men and women.

Alcohol-induced blackout.

The effects of a virtual reality treatment program for online gaming addiction

Comparative study of the effects of bupropion and escitalopram on Internet gaming disorder.

High concentrations of plasma brain-derived neurotrophic factor in methamphetamine users.