Showing papers in "Journal of Health Psychology in 2007"

A systematic review of beliefs involved in the use of complementary and alternative medicine.

Abstract: People might be attracted to and use complementary and alternative medicines (CAM) because they hold beliefs that are congruent with CAM. This article collates, examines and synthesizes the evidence surrounding this hypothesis. Most studies are cross-sectional and focus on a limited number of beliefs. Multivariate studies suggest that beliefs related to control and participation, perceptions of illness, holism and natural treatments, and general philosophies of life predict CAM use when controlling for demographic and clinical factors. Further research should examine the robustness of these relationships in different illness groups and the prospective relationships among beliefs and CAM use over time.

Applying the Gelberg-Andersen Behavioral Model for Vulnerable Populations to Health Services Utilization in Homeless Women:

Abstract: We applied the Gelberg-Andersen Behavioral Model for Vulnerable Populations to predict health services utilization (HSU) in 875 homeless US women. Structural models assessed the impact of predisposing (demographics, psychological distress, alcohol/drug problems, homelessness severity), enabling (health insurance, source of care, barriers) and need (illness) variables on HSU (preventive care, outpatient visits, hospitalizations). Homelessness severity predicted illness, barriers and less insurance. Distress predicted more barriers, illness and less outpatient HSU. Drug problems predicted hospitalizations. Barriers predicted more illness and less outpatient HSU. Health and homelessness indicators were worse for White women. Better housing, access to care and insurance would encourage appropriate HSU.

Breast and Prostate Cancer Online Discussion Boards A Thematic Analysis of Gender Differences and Similarities

Abstract: Online discussion boards are being used increasingly by cancer survivors, highlighting the need for understanding this potentially supportive communication process. Two online discussion boards, a prostate group and a breast cancer group, were studied using mixed methodology of both Grounded Theory and a quasi-numerative approach. Both men's and women's dialogues fell under two themes, information support and emotional support. Information support accounted for 60 per cent of communications in women and 64 per cent in men and emotional support 40 per cent in women and 36 per cent in men. However, there were gender differences in the language styles of these communications. Further research is recommended to understand adequately the emotional content within women's and men's dialogues in the context of breast and prostate cancer discussion boards.

'Dying twice': a multi-level model of the roots of AIDS stigma in two South African communities.

Abstract: We highlight the complex interplay of psychological and social factors driving AIDS stigma, drawing on a study of community responses to HIV/AIDS in two communities in KwaZulu-Natal, South Africa. We draw on 120 semi-structured interviews and focus groups, in which open-ended topic guides were used to explore community responses to HIV/AIDS. Drivers of stigma included fear; the availability and relevance of AIDS-related information; the lack of social spaces to engage in dialogue about HIV/AIDS; the link between HIV/AIDS, sexual moralities and the control of women and young people; the lack of adequate HIV/AIDS management services; and the way in which poverty shaped people's reactions to HIV/AIDS. We discuss the implications of our findings for stigma-reduction programmes.

Mental Health Policy Development and Implementation in Four African Countries

Abstract: The purpose of the research programme introduced in this article is to provide new knowledge regarding comprehensive multisectoral approaches to breaking the negative cycle of poverty and mental ill-health. The programme undertakes an analysis of existing mental health policies in four African countries (Ghana, South Africa, Uganda, Zambia), and will carry out and evaluate interventions to assist in the development and implementation of mental health policies in those countries, over a five-year period. The four countries in which the programme is being conducted represent a variety of scenarios in mental health policy development and implementation.

Relations between Social Support, Appraisal and Coping and Both Positive and Negative Outcomes in Young Carers

Abstract: This study examined a stress/coping model of adjustment in early caregiving. It was hypothesized that better adjustment would be related to higher social support and approach coping, and lower stress appraisals and avoidant coping. One hundred young carers aged 10-25 years completed questionnaires. Predictors included choice in caregiving, social support, stress appraisal and coping. Dependent variables were global distress and positive outcomes (life satisfaction, positive affect, benefits). Correlations supported all hypothesized relations between the stress/coping predictors and adjustment outcomes. Regression analyses showed social support as the strongest predictor of adjustment, whereas coping and choice in caregiving emerged as weaker predictors and stress appraisal was unrelated to adjustment. The stress/coping framework and findings have the potential to inform interventions designed to promote well-being in young carers.

Weight loss treatment and psychological well-being: a review and meta-analysis.

Abstract: Research suggests that weight loss treatment generally benefits psychological well-being but these effects have never been quantitatively reviewed. A meta-analysis of 117 weight loss treatment tests showed that weight loss treatment was associated with lowered depression and increased self-esteem. Treatment type moderated treatment effects on depression and self-esteem. Actual weight loss moderated treatment effects on self-esteem but not depression; only treatments that produced actual weight loss predicted increased self-esteem whereas improvements in depression were independent of weight loss. The clinical implications of the findings and the possible causal relationships among weight, depression and self-esteem are discussed.

A bitter pill: a discursive analysis of women's medicalized accounts of depression.

Abstract: Taking a discourse analytic approach, this article explores how a biomedical understanding is drawn on and mobilized in women's accounts of their depressive experiences. Through talk of diagnosis, and by drawing comparisons between depression and physical illnesses, participants constructed depression as a medical condition with the effect of validating their pain and legitimizing their identities. However, participants' accounts also indicated an uneasy fit between the objective discipline of biomedicine and their subjective experiences of depression. Without tangible evidence to validate the 'reality' of their condition, speakers were on precarious ground for talking of themselves and their distress within a biomedical frame. The social construction of biomedicine and stigma for marginalized forms of distress are discussed.

Stigma, Concealment and Symptoms of Depression as Explanations for Sexually Transmitted Infections among Gay Men

Abstract: This study examined how perceived sociocultural factors influenced the relationship between psychosocial variables and sexually transmitted infections (STIs) among gay men. A cross-sectional brief street-intercept survey was administered to 594 gay men. Analyses examined how well stigma, concealment and symptoms of depression explained variation in participants' histories of STIs. Results suggested that concealment partially mediated the relationship between stigma and depression and depression partially mediated the relationship between concealment and STIs. Controlling for sociodemographic factors, symptoms of depression explained more varied histories of STIs; however, concealment was negatively related to STIs. Implications for STI and HIV interventions are discussed.

Health and Street/ Homeless Youth

Abstract: This article reviews the Canadian literature on health issues for homeless/street youth couched in terms of the broad determinants of health. A description of the target population is presented, followed by a discussion of the health risks associated with living in marginal and precarious situations ;on the street'. In particular, the potential consequences of engaging in the risky and often dangerous activities (e.g. substance abuse and high-risk sex) associated with the street lifestyle are discussed. Key conclusions drawn from the relevant literature are taken into consideration in a final section that includes a discussion of the policy implications of this work.

A Self-determination Theory approach to the study of body image concerns, self-presentation and self-perceptions in a sample of aerobic instructors.

Abstract: This study examined motivational predictors of body image concerns, self-presentation and self-perceptions using Self-determination Theory as a guiding framework. Aerobic instructors (N = 149) completed questionnaires measuring general need satisfaction, exercise motivational regulations, body image concerns, social physique anxiety and self-perceptions. Introjected regulation predicted all outcome variables in the expected direction. Intrinsic motivation positively predicted physical self-worth. Further, autonomy need satisfaction negatively predicted body image concerns. Finally, differences existed in need satisfaction, introjected regulation, self-perceptions and social physique anxiety between those at risk of developing eating disorders and those not at risk. The results underline the importance of overall and exercise-specific feelings of self-determination in dealing with body image concerns and low self-perceptions of aerobics instructors.

Self-efficacy and overprotection are related to quality of life, psychological well-being and self-management in cardiac patients.

Abstract: This repeated-measures study explores how self-efficacy and overprotection relate to psychological well-being, health-related quality of life and self-management. Eighty-two cardiac patients, suffering from congestive heart failure (CHF) or myocardial infarction (MI), completed questionnaires at T1 and three months later. Perceived overprotection is associated with concurrent levels of anxiety and depression, and lowered quality of life. Self-efficacy is related to psychological well-being in both patient groups, but only associated with quality of life in CHF patients. In addition, self-efficacy predicts MI patients' self-management behaviours in the medium term. Findings have implications for cardiac rehabilitation, where attention may usefully be focused on enhancing self-efficacy and dealing with issues of support and overprotection by the partner.

Health inequalities and homelessness: considering material, spatial and relational dimensions.

Abstract: Homelessness is a pressing health concern involving material hardship, social marginalization and restrained relationships between homeless and housed people. This article links relational aspects of homelessness, and its health consequences, with material and spatial considerations through the use of photo-elicitation interviews with 12 rough sleepers in London. We highlight the relevance of embodied deprivation for a health psychology that is responsive to the ways in which social inequalities can get under the skin of homeless people and manifest as health disparities.

Associations of Perceived Risk and Worry with Cancer Health-protective Actions Data from the Health Information National Trends Survey (HINTS)

Abstract: This study examined the associations of susceptibility, conceptualized as both a cognition (risk) and as affect (worry) and their possible interaction, with cancer screening behaviors. Data for this study were obtained from the 2003 Health Information National Trends Survey (HINTS). Hierarchical regression models assessed the ability of risk, worry and their interaction (after controlling for other important variables) to predict cancer-screening behaviors. Results found that risk and worry (but not their interaction) were associated with regular mammography screening and having had a sigmoidoscopy or colonoscopy but with neither FOBT nor PSA screening. The findings suggest that risk and worry are both important in predicting some types of screening behavior and that these variables operate independently.

Personality, Emotional Intelligence and Exercise

Abstract: The associations of personality and self-report emotional intelligence (EI) with attitudes to exercise and self-reported exercise behaviour were investigated in a sample of 497 Canadian undergraduates. A positive attitude to exercise was negatively associated with Neuroticism and uncorrelated with other personality traits and EI. Exercise behaviour was positively associated with Extraversion and EI and negatively associated with Neuroticism. Structural equation modelling indicated that EI mediated the relationship between personality and exercise behaviour. The interpretation of this result in terms of EI having some properties of a coping style is discussed.

What do people think about when they answer theory of planned behaviour questionnaires? A 'think aloud' study.

Abstract: Two studies aiming to identify the nature and extent of problems that people have when completing theory of planned behaviour (TPB) questionnaires, using a cognitive interviewing approach are reported. Both studies required participants to 'think aloud' as they completed TPB questionnaires about: (a) increasing physical activity (six general public participants); and (b) binge drinking (13 students). Most people had no identifiable problems with the majority of questions. However, there were problems common to both studies, relating to information retrieval and to participants answering different questions from those intended by researchers. Questions about normative influence were particularly problematic. The standard procedure for developing TPB questionnaires may systematically produce problematic questions. Suggestions are made for improving this procedure.

Predictors of Homelessness among Older Adults in New York City Disability, Economic, Human and Social Capital and Stressful Events

Abstract: We interviewed 61 housed and 79 homeless adults aged 55 and over about disability; economic, human and social capital; and stressful life events prior to becoming homeless. Over half of the homeless group had previously led conventional lives. Human capital, social capital and life events were more important than disability or economic capital in predicting homelessness. The homeless adults were younger, more likely to be male and better educated than housed adults, but had shorter job tenure and fewer social ties. Homeless adults faced multiple, cascading risks, including job loss and housing loss. Implications for prevention are discussed.

Socioeconomic status and substance use behaviors in adolescents : The role of family resources versus family social status

Abstract: The aims of this study were to test the associations among socio-economic status (SES) and substance use in adolescents, and to compare the relative strength of associations for different types of SES markers, including financial resources and family social status. A total of 113 teenagers reported their substance use, and parents reported family SES. High SES teens were more likely to use substances than low SES teens. Family financial resources were a stronger predictor of substance use than family status. Programs aimed at reducing teen substance use should be aware of these risk factors when developing substance use interventions.

Critical review: nicotine for the fetus, the infant and the adolescent?

Abstract: The recent expansion of Nicotine Replacement Therapy to pregnant women and children ignores the fact that nicotine impairs, disrupts, duplicates and/or interacts with essential physiological functions and is involved in tobacco-related carcinogenesis. The main concerns in the present context are its fetotoxicity and neuroteratogenicity that can cause cognitive, affective and behavioral disorders in children born to mothers exposed to nicotine during pregnancy, and the detrimental effects of nicotine on the growing organism. Hence, the use of nicotine, whose efficacy in treating nicotine addiction is controversial even in adults, must be strictly avoided in pregnancy, breastfeeding, childhood and adolescence.

Attachment style, stigma and psychological distress among HIV+ adults.

Abstract: This study explored the role of adult attachment style in reported experiences of HIV-related stigma, stress and depression in a diverse sample of HIV+ adults. Participants (N = 288) recruited from AIDS service organizations were administered the Experiences in Close Relationships Scale, Perceived Stress Scale, CES-D, HIV Stigma Scale and a health information questionnaire. Adult romantic attachment style was significantly associated with perceived stress, depression and HIV-related stigma. Results of regression analyses supported contentions that in addition to HIV symptomatology, other psychosocial risk factors such as attachment style and stigma contribute to perceived stress and depression among HIV+ men and women.

Just thinking about it: social capital and suicide ideation among homeless persons.

Abstract: Suicide ideation is a sensitive indicator of personal well-being. While ideation occurs in roughly 3 percent of the US population annually, in this study rates are 10 times higher. This article explores the role of social capital in mediating negative life circumstances on ideation for a sample of 161 homeless adults in a mid-sized Southern US metropolitan area. Our results imply that social capital does not function the same way for homeless persons as it does for the general population. This finding supports growing evidence that social capital's much touted benefits for personal well-being may not apply to disadvantaged populations.

Relationships between felt age and perceived disability, satisfaction with recovery, self-efficacy beliefs and coping strategies.

Abstract: Subjective age is related to health and to life satisfaction, and adaptation to stressful life events is associated with self-efficacy beliefs and coping. The present study on cancer survivors addressed two objectives: the relationship between felt age and perceived disability and satisfaction with recovery, and the feeding back of felt age on general self-efficacy beliefs and coping strategies. Data were collected one and six months after surgery. Individuals with younger age identities reported lower levels of perceived disability and avoidance-oriented coping and higher levels of satisfaction with recovery, self-efficacy and meaning-focused coping than individuals with older age identities. Individuals with decreased or stable felt age indicated increased meaning-focused coping or avoidance-oriented coping, respectively. Explanations for these associations are discussed.

HIV/AIDS support and African pentecostalism: the case of the Redeemed Christian Church of God (RCCG).

Abstract: International and African discourses on the HIV/AIDS pandemic and intervention neglect the role of religion and religious organizations. Social science perspectives in tackling health and disease neglect religious doctrines and faith central to worldviews and praxis of religious groups. Both aspects are important for religious groups and individuals affected by HIV/AIDS. Informed by a religious studies paradigm and through the religious ethnography of the Redeemed Christian Church of God (RCCG) in Nigeria and the Diaspora, this article demonstrates mechanisms employed by African Pentecostals to combat the epidemic and provide support for infected members. The RCCG conceptualization of disease and healing is central to understanding responses and measures in combating HIV/AIDS.

Patient-related Factors Predicting HIV Medication Adherence among Men and Women with Alcohol Problems

Abstract: The study explored the relationship between HIV medication adherence and alcohol, cognitive, social and affective factors in 272 persons with alcohol problems. Alcohol and cognitive factors significantly differentiated those who did and did not adhere. Specifically, adherence confidence and number of drinks emerged as subfactors driving the associations to adherence. Among those who were less than perfectly adherent (n = 154), only alcohol factors predicted levels of nonadherence. Cognitive factors play a role in understanding some of the differences between those who do and do not adhere to their HIV medications, but they do not differentiate among levels of nonadherence.

Perception versus reality: an exploration of children's measured body mass in relation to caregivers' estimates.

Abstract: This study investigated the relationship between parents' reports, as compared with our obtained measurements, of their children's body status. Separate body mass index (BMI) scores were calculated based on: (1) parents' report of their children's height and weight, and (2) children's measured height and weight. Results indicate that parents' perceptions of their children's body status reliably varied from the scores obtained from our measurements, such that parents whose children classified as overweight consistently underreported their children's BMI, while parents whose children fell into the underweight category did the opposite. Implications for the potential psychological mechanisms at play in addition to how these findings might relate to the larger childhood obesity crisis in the United States and internationally are discussed.

Living with a Kidney Transplant: A Qualitative Investigation of Quality of Life

Abstract: Research has shown that transplantation improves quality of life for patients with end stage renal disease (ESRD), although it does not return to pre-kidney failure levels. This study used focus groups to explore the experience of living with a transplanted kidney. The data were analysed, using thematic analysis, and the following themes were identified: medicalization; fear; gratitude; and coping. These may necessitate constant vigilance, reduced spontaneity and preoccupation with self-care to maintain the kidney's health; being treated differently from others; pressure not to let themselves and others down; and the urge to increase their knowledge about their condition. It was found that these themes pervade the lives of the recipients and that the psychosocial effects of transplantation are long-lasting.

Risk and Protective Factors Predictive of Sense of Coherence during Adolescence

Abstract: This brief report presents a study undertaken to better understand the factors that are related to sense of coherence (SOC) levels among youth. Middle school students (N = 1619) reported on risk and protective factors across ecological domains. Analyses revealed that social support, anger expression, family conflict and neighborhood cohesion were predictors of SOC for both males and females. Community views regarding gang membership was a predictor of SOC only for males, while age was a predictor of SOC only for females. The findings suggest a resiliency and ecological framework may be helpful in understanding SOC in youth.

Factorial Invariance of the 13-item Sense of Coherence Scale across Gender:

Abstract: This study examined the gender invariance of the 13-item Sense of Coherence (SOC) scale. Confirmatory factor analyses indicated that a single factor model with one pair of correlated errors fit the data well. Invariance testing indicated that the scale is both congeneric and tau equivalent, meaning that a single latent SOC construct holds equally well for males and females, and that both genders demonstrate an equivalent pattern of factor loadings. There was little evidence in support of latent factor mean equivalence across gender. Explanations for the lack of factor mean equivalence were discussed and recommendations for future research were suggested.

Detrimental effects of falling on health and well-being in later life: the mediating roles of perceived control and optimism.

Abstract: Falling is common among older adults, often resulting in decreased functional ability and quality of life. To understand processes underlying the fall/health and well-being relationship, it is important to identify psychosocial mediators. The current study examined the impact of falling on subsequent physical health, negative emotions and physical activity among 231 young-old (<85) and old-old (85+) community-dwelling adults, and the mediating effects of global perceived control (PC) and optimism. Regression results indicated that falling predicted poorer physical health, greater negative emotions and less physical activity among old-old but not young-old adults. Falling negatively predicted PC and optimism, which mediated the effects of falling on health and well-being among the old-old group. Findings have implications for enhancing recovery from falling via bolstering PC and optimism.

An ‘Overwhelming Illness’: Women’s Experiences of Learning to Live with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis

Abstract: The processes through which people learn to live with CFS/ME are poorly understood and have not been rigorously explored within the literature. Semi-structured interviews were conducted with eight women and analysed using interpretative phenomenological analysis. Participants initially described being 'overwhelmed' by CFS/ME. Attempts at seeking help were unsatisfactory and participants described feeling let down and disbelieved. Participants reacted to this by identifying types of 'self-help' and assertively taking more responsibility for their illness and its treatment. Acquiring social support and greater knowledge were key mediating factors in the emergence of control and acceptance. The relevance of the themes to existing research and the implications for clinical practice are considered.