Showing papers in "Journal of Health Psychology in 2006"
TL;DR: A simple, practitioner-focused framework for assessing the rigour of qualitative research that attempts to be inclusive of a range of epistemological and ontological standpoints is described.
Abstract: Qualitative research has an enormous amount to contribute to the fields of health, medicine and public health but readers and reviewers from these fields have little understanding of how to judge its quality. Work to date accurately reflects the complexity of the theoretical debate required but may not meet the needs of practitioners attempting to apply qualitative work in reviews of evidence. This article describes a simple, practitioner-focused framework for assessing the rigour of qualitative research that attempts to be inclusive of a range of epistemological and ontological standpoints. An extensive review of the literature, contributions from expert groups and practitioners themselves lead to the generation of two core principles of quality: transparency and systematicity, elaborated to summarize the range of techniques commonly used, mirroring the flow of the research process. The complexities discovered are only summarized here. Finally, outstanding issues such as 'how much transparency is enough?', are flagged up.
432 citations
TL;DR: Among adults with physical illnesses, associations were found between personality and likelihood of physical limitations, especially conscientiousness, which provides a framework upon which research on complex causal processes may proceed.
Abstract: The authors' objective was to determine the association between the 'big-five' personality traits and mental and physical disorders among adults in the United States. The Midlife Development in the United States Survey, a nationally representative sample of 3032 adults ages 25-74, was used to determine the association between the five-factor traits of personality and common mental and physical disorders. Findings are consistent with and extend previous results showing that conscientiousness is associated with significantly reduced likelihood of a wide range of mental and physical disorders among adults in the general population, and inversely that neuroticism is associated with increased rates. Among adults with physical illnesses, associations were found between personality and likelihood of physical limitations, especially conscientiousness. These findings provide a framework upon which research on complex causal processes may proceed. Thus future research attention might profitably be directed to conscientiousness-relevant processes, such as adherence to health and treatment recommendations and internalization of healthy societal norms for sensible health-related behavior.
385 citations
TL;DR: This editorial reviews definitions of the concept of body image, and considers potential health consequences of lowered body satisfaction and increased body concern, contextualized within contemporary research literature around relevant themes.
Abstract: There has been a significant increase in research into body image in men, women and children in the last 20 years. This editorial reviews definitions of the concept of body image, and considers potential health consequences of lowered body satisfaction and increased body concern. The articles that form this Special Issue are contextualized within contemporary research literature around relevant themes. These include sociocultural influences, gender, effects of weight and appearance and perceptual factors. Implications of findings for health psychologists involved in designing health promotion interventions are discussed.
307 citations
TL;DR: Peer suppression of feelings, internalization of the thin-ideal and appearance comparison were significant mediators in path analyses testing the direct and indirect role of peer influences on outcome variables.
Abstract: A sample of 344 adolescent girls completed a variety of measures designed to index the associations among peer influences, body-image dissatisfaction, eating dysfunction and self-esteem. Results indicated that participants were significantly similar to their nominated friends on self-esteem, but not body image or eating disturbance. Peer measures were significantly associated with body dissatisfaction, eating problems and self-esteem. Peer suppression of feelings, internalization of the thin-ideal and appearance comparison were significant mediators in path analyses testing the direct and indirect role of peer influences on outcome variables. Implications for intervention and prevention programs are discussed.
216 citations
TL;DR: Among women with PCOS, body dissatisfaction measures and education explained 66 percent of the variance in depression, suggesting explanations of the PCOS–depression link should consider the role of potentially mediating psychosocial variables.
Abstract: Common features of polycystic ovary syndrome (PCOS), including hyperandrogenism, ovarian dysfunction and obesity, can be highly distressing. We compared 40 women with PCOS to women with infertility but not PCOS, and to women with neither PCOS nor infertility, on measures of depression and body image. Women with PCOS reported higher depression scores and greater body dissatisfaction (p < .001) than comparison group women. Body image was strongly associated with depression overall, even after controlling body mass. Among women with PCOS, body dissatisfaction measures and education explained 66 percent of the variance in depression, suggesting explanations of the PCOS-depression link should consider the role of potentially mediating psychosocial variables.
214 citations
TL;DR: The results point to differential links of insecure attachment styles with perceived support in different life-stages and to related cognitive, emotional and social processes.
Abstract: The present study examined the link between attachment, social support and well-being in young and older adults. The results from multi-group path analyses showed significant between-group differences in the links between attachment, perceived support and well-being. Anxious attachment and well-being were inversely associated and this was stronger for the younger group than it was for the older group. Avoidant attachment was negatively related to perceived support satisfaction in the older age group only, and perceived support mediated the effects of avoidant attachment on mental health and loneliness in the older group. Generally, perceived satisfaction with support was more strongly related with well-being in older adults. The results point to differential links of insecure attachment styles with perceived support in different life-stages and to related cognitive, emotional and social processes.
201 citations
TL;DR: Findings suggest participation in a pro-anorexia Internet site was multi-purpose, providing a coping function in relation to weight loss, and the contribution of sites to increased levels of eating disorders is not inevitable.
Abstract: Pro-anorexia Internet sites aim to promote, support and discuss anorexia nervosa. Media coverage has raised concerns that sites may increase the level of eating disorders. This research examines the meaning of participation in a pro-anorexia Internet site and its relationship with disordered eating by using an interpretative phenomenological analysis of fifteen separate message ‘threads’ followed over a six-week period. Four themes were identified: (1) tips and techniques; (2) ‘ana’ v. anorexia nervosa; (3) social support; and (4) need for anorexia. Findings suggest participation was multi-purpose, providing a coping function in relation to weight loss, and the contribution of sites to increased levels of eating disorders is not inevitable. Copyright © 2006 SAGE Publications
200 citations
TL;DR: Boys do not believe that the mass media influences their body image and said they do not talk about body image because it is a feminine or gay issue.
Abstract: Although a considerable and informative literature on boys' body image is beginning to emerge, this literature has been guided strongly by theorizing about female body image. The present study aimed to gain access to boys' own ideas and terminology regarding their body image. The participants (aged 14 to 16 years) said that they are satisfied with their appearance, but some conceded their physical appearance to be more important than they like to admit. Boys do not believe that the mass media influences their body image and said they do not talk about body image because it is a feminine or gay issue.
180 citations
TL;DR: In this paper, the purpose of the study was to gain an in-depth understanding of how 17 women with breast cancer in Canada and the USA used art therapy and their own art making to address their psychosocial needs, focusing particularly on meaning making.
Abstract: Art therapy (with an art therapist) and art making (without an art therapist) show promise as avenues for psychosocial support for women with breast cancer. The purpose of this study was to gain an in-depth understanding of how 17 women with breast cancer in Canada and the USA used art therapy and their own art making to address their psychosocial needs, focusing particularly on meaning making. Narrative analysis of interviews yielded four storylines: Art and Art Therapy as a Haven; Getting a Clearer View; Clearing the Way Emotionally; and Enhancing and Enlivening the Self. The storylines show existence being affirmed, confirmed and proclaimed through visual artistic expression and meaning making being achieved through physical acts of making.
151 citations
TL;DR: Investigating how individuals’ use of the Internet for finding health information may affect the relationship between health professionals and patients explores people's rationales for searching for information online, the information selection process and the implications for doctor–patient interactions.
Abstract: This article investigates how individuals' use of the Internet for finding health information may affect the relationship between health professionals and patients. It explores people's rationales for searching for information online, the information selection process and the implications for doctor-patient interactions. Qualitative interviews were conducted by email with 31 health information seekers. Study findings show the importance of the 'everyday' in orientating health information searches and of personal experience in navigating a multiplicity of online sources. Interviewees emphasize the primary role of the doctor-patient relationship for delivering health and medical information, their Internet searches complementing rather than opposing professional expertise.
148 citations
TL;DR: The ‘rubber-hand’ illusion, in which individuals misattribute tactile sensations felt by their hand to a rubber prosthetic hand that they see being stimulated, was employed to examine the relationship between perceptual body image and unhealthy body change in 128 volunteers.
Abstract: The 'rubber-hand' illusion, in which individuals misattribute tactile sensations felt by their hand to a rubber prosthetic hand that they see being stimulated, was employed to examine the relationship between perceptual body image and unhealthy body change in 128 volunteers. Variance in unhealthy body development in males (22%) and in bulimic symptomatology in both females and males (10%), was explained by susceptibility to the illusion. The illusion, which is relatively free from cognitive and emotional 'contamination', could be used to identify individuals most responsive to therapies designed to correct inaccurate body perceptions-individuals whose perceptual body image is malleable.
TL;DR: It is argued that it is more useful to consider body imaging as a process, an activity rather than a product.
Abstract: The reification of body image leads to unarticulated ideological and conceptual assumptions that obscure the most dynamic and productive features of the construct. These assumptions are that body image: (1) 'exists'; (2) is a socially mediated product of perception; (3) is 'internal' and 'of the individual'; (4) can be treated and measured as if real; and (5) individuals' respond to body image measures as if neutrally providing information about pre-existing images held in their heads. We argue that it is more useful to consider body imaging as a process, an activity rather than a product.
TL;DR: Several aspects of early adolescent girls' self-image may be adversely influenced by a heavy weight status.
Abstract: Eighty girls aged 128 (06) years, completed self-concept, depression and anxiety scales over three years and had their height and weight measured All nine self-concept domains were lower in the Highest BMI group, compared to the Lower BMI group and this trend was stable over three years Highest BMI girls were substantially lower than population norms on all nine scales Over three years, the Physical Appearance and Close Friendship scores of Highest BMI girls decreased compared to Lower BMI girls This pattern was similar for all of the other self-concept domains Several aspects of early adolescent girls' self-image may be adversely influenced by a heavy weight status
TL;DR: Results showed that viewing an accurate and empathetic movie portrayal of schizophrenia increased knowledge and the educational trailer increased not only knowledge acquisition but influenced stigma reduction.
Abstract: This study examines the effects of Entertainment-Education strategy on knowledge acquisition about schizophrenia and stigma reduction, using pretest posttest control group and 2 X 3 (advocate's perspective X message style) between-subjects factorial design. Participants watched an accurate and empathetic movie portrayal of schizophrenia, followed by an educational trailer. Participants (N= 165) were randomly assigned to one of eight conditions (six manipulated conditions, control, a group who watched a trailer prior to the movie). Results showed that viewing an accurate and empathetic movie portrayal increased knowledge. The educational trailer increased not only knowledge acquisition but influenced stigma reduction. Structural equation modeling analysis revealed that entertainment and educational value of the movie mediated stigma reduction. Implications of this study to the mental health research and the design of Entertainment-Education contents are discussed.
TL;DR: A case study of a 19-year-old man living in London, who describes himself as different to his peers on several important dimensions, including his engagement in health-related behaviours, demonstrates the importance of health- related social behaviours such as drinking, drug use, physical activity, sport and sexual behaviour in the construction of a masculine identity.
Abstract: The study of young men's health-related behaviour offers an opportunity to examine the links between masculine identity and social behaviour. This article presents a case study of a 19-year-old man living in London, who describes himself as different to his peers on several important dimensions, including his engagement in health-related behaviours. The case study demonstrates the importance of health-related social behaviours such as drinking, drug use, physical activity, sport and sexual behaviour in the construction of a masculine identity. This case study also reveals that the way in which men position themselves in relation to different discourses of masculinity can have important implications not only for their masculine identities, but also for their health-related behaviour.
TL;DR: The experimental manipulation of mediators and the demonstrated mediation effects support the conclusion that social-ecological resources can contribute to improvements in healthful lifestyles for women with type 2 diabetes.
Abstract: A study was conducted to determine if an intervention could change social support and social-ecological resources of post-menopausal women diagnosed with type 2 diabetes, and if those changes mediated the intervention's effects on health behaviors and outcomes. Women (N = 279) were randomly assigned to receive a comprehensive 6-month Mediterranean Lifestyle Program (MLP) or usual care from their physicians (UC). MLP was successful in changing social embeddedness and social-ecological resources, but not a measure of perceived support. Changes in social-ecological resources mediated intervention effects on fat consumption, exercise and glycemic control. The experimental manipulation of mediators and the demonstrated mediation effects support the conclusion that social-ecological resources can contribute to improvements in healthful lifestyles for women with type 2 diabetes.
TL;DR: Regression analyses indicated that, controlling for socio-demographic variables, more use of positive religious coping strategies was associated with more burden, yet, also more satisfaction, and correlated with an increased likelihood of Major Depressive Disorder and anxiety disorders.
Abstract: This study investigated the association between religious coping, mental health and the caring experience, as well as potential explanatory mechanisms, among 162 informal caregivers of terminally ill cancer patients. Regression analyses indicated that, controlling for socio-demographic variables, more use of positive religious coping strategies was associated with more burden, yet, also more satisfaction. In contrast, more use of negative religious coping strategies was related to more burden, poorer quality of life and less satisfaction, and correlated with an increased likelihood of Major Depressive Disorder and anxiety disorders. In a number of models, negative religious coping was related to outcomes through its relationship with social support, optimism and self-efficacy. Implications for research and healthcare are discussed.
TL;DR: This study explored the ways in which alcohol and drinking were represented in six monthly UK magazines across a threemonth period to highlight how gender, constructed in relation to the other, is an important aspect of representations of drinking patterns in young adults.
Abstract: Young adults and young women in particular are drinking more alcohol than ever before, with implications for risky behaviours and long-term health. This study explored the ways in which alcohol and drinking were represented in six monthly UK magazines (three targeted at young men, three at young women) across a three-month period (18 magazines). We identified three main discourses across the texts, namely the drug alcohol; masculinity and machismo; and drinking as normality. These discourses constructed women's and men's drinks and drinking behaviours in sharp contrast. Drinking was aligned with traditional masculine images, although new kinds of drinks were aligned with traditional feminine images--and derided in men's magazines. Findings highlight how gender, constructed in relation to the other, is an important aspect of representations of drinking patterns in young adults.
TL;DR: The use of maladaptive coping strategies to deal with the stress of living with HIV/AIDS, particularly engaging in various kinds of avoidant behaviors, was significantly associated with greater depression at baseline and increased depression at three months.
Abstract: This prospective study examined the effect of maladaptive coping strategies and psychological quality of life (QOL) on depression at two time points in a diverse sample of persons living with HIV/AIDS (N = 85). The use of maladaptive coping strategies to deal with the stress of living with HIV/AIDS, particularly engaging in various kinds of avoidant behaviors, was significantly associated with greater depression at baseline and increased depression at three months. QOL was the single most important predictor of depression. In an effort to develop effective clinical methods aimed at decreasing depression among adults living with HIV, future studies need to focus on improving quality of life and increasing adaptive coping strategies associated with the stress of living with HIV/AIDS.
TL;DR: This article examined the role played by sport in understanding adolescent males' views about their body and found that sport provided adolescent males with a context for discussing their body image, and sport was used as a forum for competing with other males both through playing sport and by using sport performance to make favourable social comparisons about their bodies.
Abstract: The present study examined the role played by sport in understanding adolescent males' views about their body. Semi-structured interviews were conducted with 40 adolescent boys aged between 15 and 17 years. An inductive thematic analysis of boys' narratives showed that sport provided adolescent males with a context for discussing their body image. Attributes which males liked about their body were synonymous with those associated with being successful at sport. In addition, sport was used as a forum for competing with other males both through playing sport and by using sport performance to make favourable social comparisons about their body size.
TL;DR: It is concluded that intervention programmes need the support of the body building community in order to be effective and Steroid Use vs Abuse; Side-effects; Trusted Information Sources; and Social Pressure emerged.
Abstract: This study was designed to investigate anabolic steroid users' experiences of, and motivations for, use. Five men and six women users took part in in-depth interviews. Four themes emerged: Steroid Use vs Abuse; Side-effects; Trusted Information Sources; and Social Pressure. Many users believed that steroids used in moderation were safe. Serious side-effects (liver and kidney damage, hypertension) were not significant disincentives. Information from health professionals tended to be mistrusted because it was not based on first-hand experience of use. Social support, especially from within the body building community, was an important motivator. It is concluded that intervention programmes need the support of the body building community in order to be effective.
TL;DR: Media representations of the indigenous Maori of Aotearoa, New Zealand are frames to reflect the media contribution to maintenance and naturalisation of colonial relationships and seek to include critical media scholarship in a critical public health psychology.
Abstract: International literature has established that racism contributes to ill-health of migrants, ethnic minorities and indigenous peoples. Racism generally negates wellbeing, adversely affecting physical and psychological health. Numerous studies have shown that media contribute marginalizing particular ethnic and cultural groups depicting them primarily as problems for and threats to the dominant. This articles frames media representations of, and their effect on, the indigenous Maori of Aotearoa, New Zealand within the ongoing processes of colonization. We argue that reflects the media contribution to maintenance and naturalisation of colonial relationships and seek to include critical media scholarship in a critical public health psychology.
TL;DR: Reflection and critique of psychology and its uses in public health is needed for theoretical and morally reasons and points to inseparability of Psychology and politics.
Abstract: Behaviour oriented health promotion has often relied on over-simplistic and over-deterministic models in which action emanates from individuals, not the social or economic structures they inhabit. Mainstream health psychology models are allied with official health ideology and policy, stressing self-control, self-regulation and responsible (low-cost) health citizenship. Discussion of psycho-political validity and of the use of a wider community of meanings and theories is welcome and moves beyond narrow disciplinary concerns by developing epistemological self-critique. Reflection and critique of psychology and its uses in public health is needed for theoretical and morally reasons and points to inseparability of psychology and politics.
TL;DR: Content analysis revealed a number of themes related to adherence to CP, which included problems with fitting CP into lifestyle, a perception that CP does not help, physical consequences of CP, doing exercises instead and doing CP as and when necessary.
Abstract: Chest physiotherapy (CP) is seen as a cornerstone of Cystic Fibrosis (CF) treatment. However, previous studies have suggested that adherence to CP is low. This study of adults with CF (N = 563) investigated CP adherence and associated factors. Only 29.5 per cent reported undertaking daily CP. Predictors of adherence included problems with fitting CP into lifestyle, a perception that CP does not help, physical consequences of CP, doing exercises instead and doing CP as and when necessary. These variables accounted for 45 per cent of the variance in adherence. Content analysis revealed a number of themes related to adherence to CP. Future studies should explore the benefits of daily CP and attempt to devise simple interventions to maximize adherence to CP.
TL;DR: It was concluded that early experiences of both physical activity and media use during childhood and adolescence play an important role in the development of adult women's body image.
Abstract: This study aimed to investigate the effects of both past and current physical activity and media use on women's body image. A sample of 144 female undergraduate students completed measures of current physical activity, media use and body image, as well as providing retrospective reports of their physical activity participation and media usage during childhood and adolescence. Regression analyses showed that childhood experiences of physical activity and media use predicted adult body-image concerns more strongly than current activities. It was concluded that early experiences of both physical activity and media use during childhood and adolescence play an important role in the development of adult women's body image.
TL;DR: The findings reinforce the applicability of SDT to understanding the quantity and quality of engagement in exercise and the role of motivational regulations in this regard.
Abstract: Background Pulling from Self-Determination Theory (SDT; Deci & Ryan, 1985), this study examined whether individuals classified as 'nondependent-symptomatic' and 'nondependent-asymptomatic' for exercise dependence differed in terms of reported levels of exercise-related psychological need satisfaction, self-determined versus controlling motivation and exercise behavior. In addition, we examined the type of motivational regulations predicting exercise behavior among these different groups, and their role as mediators between psychological need satisfaction and behavioral outcomes. Methods Participants (N = 339) completed measures of exercise-specific psychological need satisfaction, motivational regulations, exercise behavior and exercise dependence. Results Nondependent-symptomatic individuals reported higher levels of competence need satisfaction and all forms of motivational regulation, compared to nondependent-asymptomatic individuals. Introjected regulation approached significance as a positive predictor of strenuous exercise behavior for symptomatic individuals. Identified regulation was a positive predictor of strenuous exercise, and completely mediated the relationship between competence need satisfaction and strenuous exercise behavior, for asymptomatic individuals. Conclusions The findings reinforce the applicability of SDT to understanding the quantity and quality of engagement in exercise.
TL;DR: In this article, a focus-group study was conducted to examine GPs' perceptions of patients with medically unexplained symptoms (MUS), focusing on stressing situations, emotional reactions and coping strategies.
Abstract: General practitioners (GPs) often meet patients with medically unexplained symptoms (MUS). From a patient perspective, MUS is a well-acknowledged problem within the primary health care services today, but less is known about the GPs' perceptions. This study aims to elucidate GPs' perceptions of patients with MUS, focusing on stressing situations, emotional reactions and coping strategies. Twenty-seven physicians participated in focus-group discussions. In the analysis, where a phenomenographic approach was used, six situations were identified as being especially stressful in the encounter with these patients. The GPs described how they used both problem-focused and emotion-focused strategies, but with emotion-focused strategies slightly dominating, indicating that the GPs had difficulties in managing their own stress when working with patients with MUS.
TL;DR: It is argued that the present research focus is substantially medicalized, privileging the investigation and framing of certain topics, such as the portrayal of health professionals, medical practices, specific diseases and lifestyle-orientated interventions, and restricting attention to social determinants of health as appropriate topics for investigation.
Abstract: This article outlines reasons why psychologists should concern themselves with media processes, noting how media are central to contemporary life and heavily implicated in the construction of shared understandings of health. We contend that the present research focus is substantially medicalized, privileging the investigation and framing of certain topics, such as the portrayal of health professionals, medical practices, specific diseases and lifestyle-orientated interventions, and restricting attention to social determinants of health as appropriate topics for investigation. We propose an extended agenda for media health research to include structural health concerns, such as crime, poverty, homelessness and housing and social capital.
TL;DR: TPB is a fairly useful model for predicting behaviour and important information can be gained when other measures of intention are explored.
Abstract: This study examined the utility of the theory of planned behaviour (TPB) along with additional constructs in predicting exercise, and explored the motivational antecedents of exercise intentions. Participants included 162 Canadian University College students (61% females). Measures of TPB, autonomous and controlling intention, perceived autonomy support and core autonomous intention were completed during phase 1 of data collection. Two and three weeks later behaviour was assessed. Hierarchical regression analyses revealed that: (a) attitude and perceived behavioural control significantly predicted TPB intention and core autonomous intention; (b) subjective norm predicted controlling intention; and (c) perceived autonomy support predicted autonomous and core autonomous intention. TPB intention significantly predicted behaviour. TPB is a fairly useful model for predicting behaviour and important information can be gained when other measures of intention are explored.