bluuebunny/crossref_metadata_2025 huggingface dataset:
The factor structure of the BDI in facial pain and other chronic pain patients: A comparison of two models using confirmatory factor analysis
Authors: Miles Anne , McManus Chris , Feinmann Charlotte , Glover Lesley , Harrison Sheelah , Pearce Shirley
Published: February 2003

Objectives. 1) To compare two measurement models of the BDI in chronic pain sufferers to see which provides the better fit; 2) to assess whether model fit differs for a facial pain sample compared to a sample of pain sufferers attending a multidisciplinary pain clinic; and 3) to establish which affective and somatic sub‐scales of the BDI could be used in chronic pain research.

Design. Two groups of chronic pain sufferers, a facial pain group, and a group attending a multidisciplinary pain clinic completed self‐report questionnaires on pain (Multidimensional Pain Inventory), depression (BDI), and measures of anxiety and depression‐related pain cognitions (the Spielberger State‐Trait Anxiety Inventory and the Pain Cognitions Questionnaire). The measurement models of the BDI were tested using LISREL structural equation modelling and their construct validity examined using partial correlation analysis.

Method. A total of 173 people attending a multidisciplinary pain clinic and 157 patients attending a facial pain clinic completed self‐report measures of pain and mood prior to their respective clinical consultations.

Results. The model offered by Novy et al. (containing one affective factor ‘Negative‐attitude suicide’ and two somatic factors‘Performance difficulty’ and‘Physiological manifestations’) fitted both pain groups better than the model offered by Williams and Richardson (containing one affective factor ‘Self‐reproach’, one somatic factor ‘Somatic disturbance’ and one factor with a mixture of both affective and somatic items ‘Sadness about health’). However, when the factors were allowed to correlate in the latter model, both models were broadly equivalent.

Conclusions. The two measurement models adequately fitted data in both pain samples when the factors were allowed to intercorrelate in the Williams and Richardson model. Both the affective scales offered by both models could be used in future research, although the somatic factor offered by the Williams and Richardson model offered much higher levels of internal reliability than either of those offered in the Novy et al. model. The findings are discussed in relation to the issue of depression in chronic pain.
Psychophysiological effects of relaxation training in children
Authors: Lohaus Arnold , Klein‐Heßling Johannes , Vögele Claus , Kuhn‐Hennighausen Christiane
Published: February 2003

Objectives. This study compares the effects of progressive muscle relaxation and an imagery‐based relaxation training on childrens' physiological and subjective responses in a randomized controlled trial.

Design. Sixty‐four children aged 9 to 13 years were randomly allocated to either one of three experimental conditions: progressive muscle relaxation, imagery‐based relaxation or a control condition (neutral story). There were five training sessions in each condition.

Method. Heart rate (HR), skin conductance level (SCL), and skin temperature (ST) were measured continuously during a 5‐minute baseline period, an 8‐minute relaxation training period, and a 5‐minute follow‐up in each session. In addition, subjective ratings of mood and physical well‐being were collected intermittently.

Results and conclusions. A physiological pattern indicating relaxation was most clearly associated with the imagery‐based relaxation approach (decreases in HR and SCL), although ST remained unchanged. In contrast, progressive muscle relaxation led to an increase in HR during the training. The neutral story condition showed a similar trend as the imagery‐based relaxation approach (although not reaching statistical significance). Furthermore, children's ratings of positive mood and physical wellbeing increased during baseline and training periods, but there were no differences between training conditions. The results indicate psychophysiological effects of relaxation instructions which, however, are not specific for systematic relaxation training.
Effective approaches to persuading pregnant women to quit smoking: A meta‐analysis of intervention evaluation studies
Authors: Kelley Kate , Bond Rod , Abraham Charles
Published: February 2003

Objectives. The study aimed to: (1) assess the effectiveness of prenatal smoking cessation interventions, (2) clarify whether the psychological changes targeted by interventions are related to their effectiveness, (3) identify specific intervention components associated with greater effectiveness, and (4) establish whether aspects of evaluation methodology are associated with a greater effectiveness.

Design. Differences in proportions of women quitting and odds ratios were calculated for the intervention and control groups. Interventions were categorized in relation to the main intervention target(i.e. cognitive preparation versus increased threat perception), use of follow‐up contact, use of individual cessation counselling and other characteristics. Methodological approaches to evaluation were also categorized.

Methods. A systematic literature review generated 36 controlled evaluations, including one unpublished study. A meta‐analysis was used to relate study classifications to effectiveness. This involved univariate analyses and a multivariate model of the relationship between observed univariate effects.

Results. A weighted mean odds ratio of 1.93 indicated a good overall effectiveness. Cognitive preparation interventions achieved higher quit rates (6.5%) compared to interventions focusing on threat perception (2.2%). However, this effect was not maintained in the multivariate analysis.

Conclusion. Interventions should employ follow‐up, but further research is required to assess the impact of one‐to‐one counselling. Clarification of the psychological change processes underlying the observed effectiveness of these interventions is required. Future research should seek to identify the active ingredients and cognitive mediators of successful interventions.
Stress in chronic disease: Do the perceptions of patients and their general practitioners match?
Authors: Heijmans Monique , Foets Marleen , Rijken Mieke , Schreurs Karlein , de Ridder Denise , Bensing J.
Published: February 2003

Objective. To compare the stressors accompanying chronic disease as perceived by patients and their GPs and to explore how incongruence in patients' and GPs' ideas influences patients' health status and use of health care.

Method. A total of 580 patients with a diagnosis of diabetes or osteoarthritis and their GPs were interviewed by questionnaire about the stressors accompanying a patient's illness. In addition, information was obtained from each patient on health status and use of health care.

Results. The results show that patient and GP diverge in the way they think about chronic illness. Incongruence was larger in the case of osteoarthritis. In both diabetes and osteoarthritis, incongruence between patient and GP was associated with a worse health status of the patient and an increase in health‐care use, although the pattern of correlation differed by type of disease.

Conclusions. A chronic disease requires an ongoing relationship between patient and GP over years. Therefore, it is especially important that providers recognize the problems with which chronic disease patients are faced. Too often, providers are one‐sided focused on the medical aspects of disease, neglecting the personal impact that a chronic disease has on the patient's life. In this way, successful treatment is complicated.
Social behaviour and illness information interact to influence the peer acceptance of children with chronic illness
Authors: Alderfer Melissa A. , Wiebe Deborah J. , Hartmann Donald P.
Published: February 2003

Objectives. Social behaviour was investigated as a contributor to the peer acceptance of children with chronic illness. We predicted that children with illness would receive less acceptance than children without illness, and that prosocial behaviour would improve acceptance, while aggressive behaviour would hamper it. Based upon attribution and cognitive bias theories, we also predicted that prosocial behaviour would be more beneficial and aggressive behaviour less damaging to the acceptance of children with illness compared to healthy children.

Design. A 3 (social behaviour: prosocial, aggressive, no information) × 2 (physical status: chronically ill, healthy) within‐subjects analogue design was used.

Methods. Preadolescents (N = 149) indicated social acceptance of hypothetical children portrayed in vignettes as either chronically ill or healthy with prosocial, aggressive, or no social behaviour. A 13‐item social intentions scale gauged acceptance.

Results. The hypotheses were supported. Although children described as ill received lower acceptance ratings than healthy children, prosocial/ill children were more accepted than aggressive/ill children. Social behaviour interacted with physical status to affect acceptance.

Conclusions. Social behaviour influences the peer acceptance of hypothetical children with chronic illness. Prosocial behaviour enhances acceptance of children described with illness, while aggressive behaviour hampers it. Additionally, prosocial behaviour is more beneficial, and aggressive behaviour is less damaging for children described as ill versus healthy. The potential processes by which peers judge acceptance of children with illness are discussed.
Behavioural treatment for sleep problems in children with severe intellectual disabilities and daytime challenging behaviour: Effect on mothers and fathers
Authors: Wiggs Luci , Stores Gregory
Published: February 2003

Objectives. The study aimed to assess the mental state of mothers and fathers following successful behavioural intervention for sleep problems in such children.

Design. A randomized controlled trial of behavioural interventions for sleep problems.

Methods. Parents of 15 children with severe intellectual disabilities, severe sleep problems, and challenging daytime behaviour received treatment for the child's sleep problem and were compared with 15 controls who received no treatment. Parental stress, sleepiness, locus of control, perceived control, and satisfaction with aspects of sleep were assessed.

Results. Successful treatment benefited the mothers, reducing stress, increasing perceived control and making them more satisfied with their sleep, their child's sleep, and their ability to cope with their child's sleep. Positive effects in the fathers were limited to increased satisfaction with their own sleep and their child's sleep; fathers tended to feel less control following treatment. Maternal sleepiness and perceived control, and aspects of parental satisfaction showed improvements in both the treatment and control groups.

Conclusion. The effects of childhood sleep problems, and their resolution using behavioural interventions, may be different in mothers and fathers. This highlights the need to assess all family members in order to gain a greater understanding of how best to help families as a whole. The improvements in both control and treatment groups indicate that there may be non‐specific effects of taking part in the study that played a therapeutic role.
One‐year follow‐up effects of two obesity treatments on psychological well‐being and weight
Authors: Nauta Helga , Hospers Harm , Jansen Anita
Published: February 2003

Objectives. The effectiveness of a cognitive and a behavioural treatment for obese binge eaters and obese non‐binge eaters was evaluated at 1‐year follow‐up. Furthermore, we examined the role of weight changes on psychological well‐being at 1‐year follow‐up.

Design and method. Participants were reassessed 6 months and 1 year after they had finished a group cognitive treatment or a group behavioural treatment. The outcome measures were; psychological well‐being (concerns about shape, weight and eating, self‐esteem and depression), binge eating, and weight.

Results and conclusions. Analyses on the completers' sample revealed that both treatments had a markedly positive and lasting impact on shape concern, weight concern and eating concern, binge eating, self‐esteem, and depression at 1‐year follow‐up. Cognitive treatment was not superior to behavioural treatment on most outcome measures. This might be due to selective drop‐out. Analyses including non‐responders showed that the cognitive treatment was superior on shape, weight and eating concern, and binge eating. The 1‐year follow‐up results for weight‐loss were disappointing. Between pre‐treatment and 1‐year follow‐up participants in the behaviour treatment lost 3.0 kg, while participants in the cognitive treatment lost 0.3 kg. However, participants who gained weight were as successful on changes in psychological well‐being changes as participants who lost weight.
Cardiac coping style, heartbeat detection, and the interpretation of cardiac events
Authors: Kohlmann Carl‐Walter , Ring Christopher , Carroll Douglas , Mohiyeddini Changiz , Bennett Paul
Published: February 2003

Objectives. Vigilance to, and avoidance of, cardiac sensations and symptoms were explored in three studies.

Design and methods. In the first study, a self‐report measure of cardiac vigilance and cardiac avoidance, the Cardiac Coping Inventory (CCI), was administered to 453 students, and its factor structure, internal consistency, and test‐retest reliability were established. In the second, 31 undergraduates completed the CCI, and their cardioceptive sensitivity was measured on a heartbeat detection task. In a third study of 91 patients with suspected myocardial infarction, the role of coping styles in symptom interpretations was analysed.

Results. Cardiac avoidance and vigilance were independent of general symptom reporting tendencies. Cardiac vigilance was negatively correlated with heartbeat detection. Among the patients, delay in seeking treatment was predicted by the perceived importance of chest pain, which was influenced by the intensity of chest pain and cardiac vigilance.

Conclusions. Although individuals high in cardiac vigilance do not seem to be good detectors of their heartbeats in the laboratory, they appear to attach importance to heart symptoms in real life, resulting in a health‐protective behaviour.
Personality and coping traits: A joint factor analysis
Authors: Ferguson Eamonn
Published: February 2003

Objectives. The main objective of this paper is to explore the structural similarities between Eysenck's model of personality and the dimensions of the dispositional COPE. Costa et al. {Costa P., Somerfield, M., & McCrae, R. (1996). Personality and coping: A reconceptualisation. In (pp. 44‐61) Handbook of coping: Theory, research and applications. New York: Wiley} suggest that personality and coping behaviour are part of a continuum based on adaptation. If this is the case, there should be structural similarities between measures of personality and coping behaviour. This is tested using a joint factor analysis of personality and coping measures.

Design. Cross‐sectional survey.

Methods. The EPQ‐R and the dispositional COPE were administered to 154 participants, and the data were analysed using joint factor analysis and bivariate associations.

Results. The joint factor analysis indicated that these data were best explained by a four‐factor model. One factor was primarily unrelated to personality. There was a COPE‐neurotic‐introvert factor (NI‐COPE) containing coping behaviours such as denial, a COPE‐extroversion (E‐COPE) factor containing behaviours such as seeking social support and a COPE‐psychoticism factor (P‐COPE) containing behaviours such as alcohol use. This factor pattern, especially for NI‐ and E‐COPE, was interpreted in terms of Gray's model of personality {Gray, J. A.(1987) The psychology of fear and stress. Cambridge: Cambridge University Press}. NI‐, E‐, and P‐COPE were shown to be related, in a theoretically consistent manner, to perceived coping success and perceived coping functions.

Conclusions. The results indicate that there are indeed conceptual links between models of personality and coping. It is argued that future research should focus on identifying coping ‘trait complexes’. Implications for practice are discussed.
Persuading school‐age cyclists to use safety helmets: Effectiveness of an intervention based on the Theory of Planned Behaviour
Authors: Quine Lyn , Rutter D. R. , Arnold Laurence
Published: February 2003

Objectives. To design and evaluate a theory‐based intervention to encourage the use of protective helmets in school‐age cyclists.

Design. Two‐by‐three mixed design on 97 cyclists who did not initially use a helmet: Condition (intervention/control) × Time (pre‐intervention/immediately post‐intervention/5‐month follow‐up).

Method. The intervention builds on a previous study using the Theory of Planned Behaviour in which we identified a small number of salient beliefs that predict intention to use a safety helmet and helmet use (Quine et al., 1998). Participants were randomly assigned to intervention or control conditions. The intervention group was presented with a booklet containing a series of persuasive messages based on the identified salient beliefs, and the control group was presented with a different series of messages concerning a cycling proficiency and bicycle maintenance course. Initial beliefs were measured just before the intervention at Time 1, by questionnaire. The immediate effects of the intervention were evaluated by questionnaire at Time 2. Five months later, at Time 3, the long‐term effects of the intervention on beliefs, intentions, and behaviour were assessed.

Results. The behavioural, normative and control beliefs and intentions of intervention participants became more positive than those of control participants, and the effect was maintained over time. There was also a significant effect on behaviour: at 5‐month follow‐up, none of the 49 control children had taken up helmet wearing, while 12 (25%) of the 48 intervention children had.

Conclusions. The results suggest that in order to promote lasting helmet use in young cyclists, we need to change their beliefs. The intervention reported here may present an inexpensive solution to the problem of persuading adolescents to use safety helmets. The results point to the value of social cognition theories such as the Theory of Planned Behaviour in the design of effective interventions to change health behaviours.
Salient beliefs and intentions to prescribe antibiotics for patients with a sore throat
Authors: Walker A. E. , Grimshaw J. M. , Armstrong E. M.
Published: February 2003

Objectives. General practitioners (GPs) in the UK continue to prescribe antibiotics for patients with sore throats despite evidence that they are ineffective and can contribute to the growth of antibiotic resistance in the population. This study uses the theory of planned behaviour (TPB) to investigate the strength of intention to prescribe antibiotics, and to identify the salient beliefs associated with this intention.

Design. Cross‐sectional study testing hypotheses derived from the TPB.

Method. A 66‐item postal questionnaire was distributed to a random sample of GPs in one NHS region (N = 185). The questionnaire included measures of intention to prescribe antibiotics, attitude, behavioural beliefs and evaluations, normative beliefs and evaluations, perceived behavioural control, control beliefs, and past prescribing.

Results. Two‐thirds of the GPs returned complete questionnaires (N = 126, 68%). The majority intended to prescribe antibiotics for less than half of their patients with sore throats (N = 69, 55%). The variables specified in TPB predicted 48% of the variance in intention, with past behaviour adding a further 15%. Seven salient beliefs distinguished between doctors who intend to prescribe antibiotics and those who do not.

Conclusions. Attitudes towards antibiotics and control beliefs are important predictors of intention to prescribe, as predicted by TPB. Interventions could target salient beliefs associated with motivation to prescribe.
Perceptions of threat, benefits, and barriers in breast self‐examination amongst young asymptomatic women
Authors: Umeh Kanayo , Rogan‐Gibson Joanne
Published: February 2003

Aim. Young age at diagnosis of breast cancer is a negative prognostic factor, but early detection of breast pathology may improve prognosis. The present study examined the role of health perceptions (Health Belief Model; HBM) in young women's breast self‐examination (BSE). It was hypothesized that cues to action, health motivation, and perceptions of threat (vulnerability, severity), benefits, and barriers, will predict BSE, but that threat perceptions will be more powerful predictors than benefits and barriers.

Method. Questionnaire data from 178 asymptomatic women (aged 18‐35 years) living in the northwestern region of England were analysed.

Results. Using hierarchical logistic regression controlling for demographic factors, only severity and barriers emerged as important predictors; lower perceived seriousness of breast cancer and fewer perceived obstacles to practising BSE predicted performance of BSE. For every unit increment on the severity and barrier scales, the odds of a respondent performing BSE decreased by approximately 8 and 20%, respectively.

Conclusions. The results provide qualified support for the HBM. Perceived barriers was the most powerful predictor, although respondents assessed breast‐cancer severity based on early detection through BSE. Implications for clinical interventions are considered.
Psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) among female cardiac patients
Authors: Roberts Susan B. , Bonnici Dean M. , Mackinnon Andrew J. , Worcester Marian C.
Published: February 2003

Objectives. To examine the dimensionality, structure, and reliability of the HADS among female cardiac patients.

Design. Data were collected by self‐administered questionnaires at two times ‐ admission to hospital and at 2‐month follow‐up.

Method. Confirmatory factor analysis was used to examine the dimensionality and structure of the HADS. Internal consistency was assessed by computing Cronbach alpha. Pearson product‐moment correlation coefficients were calculated to assess test‐retest reliability.

Results. A two‐factor model, in which the subscales were permitted to correlate, was found to provide a good fit to the scale's 14 items compared to single factor and orthogonal two‐factor models. These two factors explained 41.4% of the total variance. The anxiety and depression subscales were moderately correlated (r = .60), with good internal consistency and test‐retest reliability found for the subscales and total HADS scores.

Conclusions. These results provide support for the HADS as a reliable measure for the assessment of anxiety and depression symptomatology among female cardiac patients.
Physical contact experience and coping ability: A study of survivors of myocardial infarction
Authors: Cochrane Nils
Published: February 2003

Objective. This study investigates the hypothesis that interpersonal physical contact experience contributes importantly to the capacity to cope with stress.

Design. Participants with differing physical contact experience were compared in respect of their coping with a standard adverse life event.

Method. A total of 137 survivors of a first myocardial infarction was assessed for their physical contact experience and/or their coping when admitted to hospital, at discharge and then 3 months later. Also, at 6 months post‐infarct and 6 months post‐discharge respectively, data relevant to their coping were collected from hospitals and general practitioners.

Results. The participants with satisfactory and unsatisfactory physical contact experience did not differ on measures of stress and general coping. However, those with satisfactory experience emerged as having adjusted significantly better psychologically than those with negative experience in childhood and the present combined. Yet, the ‘satisfactory’ participants also spent a significant 5 days longer in hospital and increased their GP usage more than twice as much as their ‘unsatisfactory’ counterparts.

Conclusions. Each kind of physical contact experience may be linked with a different aspect of coping ability, satisfactory experience with psychological adjustment, and unsatisfactory experience with physical resilience.
The influence of poster prompts on stair use: The effects of setting, poster size and content
Authors: Kerr Jacqueline , Eves Frank F. , Carroll Douglas
Published: February 2003

Objectives. There is evidence that poster prompts increase stair use. The present study was concerned with the effects of poster size, poster message, and setting on stair use.

Design. Using a quasi‐experimental design, four observational studies were undertaken in which stair and escalator use were logged during 2‐week baseline periods and 2‐week intervention periods.

Methods. In the first two studies, observations were undertaken in two shopping centres (total N = 30,018) with the size of poster varying. In the other two studies (total N = 37,907), one in a shopping centre and one in a train station, two poster messages were tested in both sites.

Results. Pedestrian traffic volume was controlled for statistically. There were significant increases in stair use with A1‐ and A2‐, but not A3‐size posters. Overall, the two different poster messages were both effective in encouraging stair use. Interactions between gender and message setting, however, reflected the fact that the ‘stay healthy, save time’ poster had little impact on female shoppers but was highly effective for female commuters.

Conclusion. These results suggest that developers of health‐promotion posters pay attention to poster size. They also indicate that it is insufficient to segment audiences by gender without considering the setting and motivational context.
Ironic processes in the eating behaviour of restrained eaters
Authors: Boon Brigitte , Stroebe Wolfgang , Schut Henk , Ijntema Richta
Published: February 2003

Theory. The present study examines the processes underlying the disinhibition of the eating behaviour of restrained eaters following negative emotions. Based on Herman and Polivy's (1984) Boundary Model and Wegner's Ironic Process Theory(1994), the limited capacity hypothesis is formulated, suggesting that overeating in restrained eaters results from cognitive capacity limitations. Predictionswere that (1) impairment of cognitive capacity during eating will lead to overeating in restrained but not in unrestrained eaters and that(2) this difference should only emerge with food perceived to be high in calories.

Method. The hypotheses were tested in an experiment with a 2 (restrained/unrestrained) × 2 (distraction yes/no) × 2 (perceived calories high/low) design, in which subjects consumed ice‐cream in a taste test situation. Ice‐cream consumption was the dependent variable.

Results. A second‐order interaction was found: as predicted, in the high calorie condition restrained eaters ate the same amount as unrestrained eaters when not distracted, but considerably more when distracted. There was also an unexpected main effect of distraction, which indicated that restrained as well as unrestrained eaters ate more if distracted than if not distracted.

Discussion. The restraint×distraction×perceived calories interaction can be explained by both the Ironic Process Theory and the Boundary Model; and the limited capacity hypothesis appears to be confirmed. The overall main effect of distraction remains puzzling. Two speculative views for the latter effect are offered.
Attitudes to doctors and medicine: The effect of setting and doctor‐patient relationship
Authors: Conroy Ronán M. , Teehan Maeve , Siriwardena Ruwani , Smyth Olive , McGee Hannah M. , Fernandes Paula
Published: February 2003

Objective. There have been few studies of attitudes to doctors and medicine, despite their potential importancein health psychology. The present study examines the effect on attitudes of setting (general practice vs. antenatal) and context (specific doctors vs. doctors in general).

Method. Interview survey of 167 antenatal attenders and 113women general practice attenders, using an extended form of the Attitudes to Doctors and Medicine Scale of Marteau (1990).

Results. Although antenatal attenders expressed more positive attitudes to doctors and medicine than general practice attenders, differences were small, and only statistically significant for 4 of 19 scale items. Compared with ratings of doctors in general, however, patients gave much more positive ratings to both their family doctor and the antenatal clinic doctors, the latter being rated higher than the former. Antenatal doctors were most likely to be rated as good doctors, to have the patient's absolute confidence, and to know what was best for them (all p<.001). The scale factor structure originally reported by Marteau could not be confirmed.

Discussion. The results suggest that attitudes to doctors and medicine are strongly dependent on whether general stereotypes or particular experiences are assessed. They also suggest that the therapeutic context may be an important factor in the formation of attitudes.
The prevalence and persistence of depression and anxiety following myocardial infarction
Authors: Lane Deirdre , Carroll Douglas , Ring Christopher , Beevers D. Gareth , Lip Gregory Y. H.
Published: February 2003

Objectives. This study was designed to assess the prevalence and persistence of symptoms of depression and anxiety during the first 12 months following acute myocardial infarction (MI).

Design and methods. In a prospective study, 288 MI patients were assessed for symptoms of depression and anxiety using the Beck Depression Inventory (BDI) and the State‐Trait Anxiety Inventory (STAI) in hospital,2‐15 days following MI, and 4 and 12 months subsequently.

Results. During hospitalization, 89 (30.9%) and 75 (26.1%) patients registered elevated BDI scores (≥10) and state anxiety scores (≥40), respectively. The 4 and 12 month prevalence rates were 37.7% and 37.2% for depressive symptoms, and 41.8% and 40.0% for anxious symptoms, respectively. Depression and anxiety were highly co‐morbid, with 51% of patients experiencing significant levels of depressive and anxious symptoms at baseline. More than half the patients with complete BDI and state anxiety data experienced either elevated symptoms of anxiety or depression throughout the first year following MI.

Conclusions. Symptoms of depression and anxiety are prevalent, persistent problems during the first year following MI. This study highlights the importance of routine psychological assessment for MI patients both in hospital and after discharge.
Environmental illness prevalence: A population‐based study in Nova Scotia
Authors: McGlone Jeanette , Rowan Paul J. , Davidson Karina , McLean David R.
Published: February 2003

Objectives. Clinic studies demonstrate that people diagnosed with environmental illness experience high levels of disability and health care utilization. Even though the controversial status of this disorder attracts attention, actual prevalence estimates and estimated impact on health care systems are unclear. To address this, we sought both a prevalence estimate and a measure of the degree of health care utilization for those reporting this diagnosis.

Design and methods. Point prevalence, as assessed by self‐report of professional diagnosis, was established with data from the Nova Scotia Health Survey 1995, a stratified, random sample population survey of 3227 Nova Scotian adults. We compared medical care utilization for the year following the survey, drawn from the provincial medical insurance register, between the 24 cases with no other reported medical conditions and 48 age‐, sex‐, and education level‐matched healthy controls.

Results. The adjusted point prevalence of environmental illness was 2.6%. Physician reimbursement costs across the following year were 5.5 times more likely to be above the survey average ($259 CAD) when compared to the healthy control group.

Conclusions. The prevalence of environmental illness diagnoses represents a significant disability and treatment burden, justifying research into case definition and the phenomenology of environmental illness by health psychologists.
An exposure‐based examination of the effects of written emotional disclosure
Authors: Kloss Jacqueline D. , Lisman Stephen A.
Published: February 2003

Objectives. We undertook this study to clarify the operative mechanisms that account for the relationship between emotional disclosure and health. We hypothesized that emotional disclosure via writing was a form of exposure‐based therapy and that exposure was the active therapeutic component.

Design and method. A group of 129 male and female undergraduates were randomly assigned to three writing groups: (1) a trauma disclosure writing group; (2) a positive emotion writing group to control for affect arousal; and (3) a neutral writing group to control for any affect arousal ‐ either positive or negative. Process measures were taken before and after each 3‐day, 20‐minute writing session. All participantscompleted questionnaires that assessed psychological and physical functioning at both the baseline and the end of the semester (approximately 9 weeks later).

Results. Groups reported differential affective arousal as well as disclosure themes in accord with our predictions. We did not replicate the findings of Pennebaker and his colleagues (e.g. Pennebaker & Beall, 1986). In our study, physical health outcome measures did not differ between groups by the end of the semester, nor did psychological measures change from baseline to follow‐up.

Conclusions. We found only limited support for the hypothesis that exposure best explains the effects of written self‐disclosure. Implications for future research in this area are discussed.
The affective beneficence of vigorous exercise revisited
Authors: Hall Eric E. , Ekkekakis Panteleimon , Petruzzello Steven J.
Published: February 2003

Objectives. High exercise intensity may be associated with reduced adherence to exercise programmes, possibly because it is perceived as aversive. However, several authors have suggested that an intensity as high as 60% or 70% of maximal aerobic capacity (VO2max) is necessary for exercise to elicit positive affective changes. To elucidate this discrepancy, the affective responses to increasing levels of exercise intensity were examined.

Design. In total, 30 volunteers rated their affect every minute as they ran on a treadmill while the speed and grade were progressively increased.

Method. The methodology was unique in three respects: (1) affect was assessed in terms of the dimensions of the circumplex model instead of distinct affective states, (2) affect was assessed repeatedly before, during, and after exercise, not only before and after, and (3) exercise intensity was standardized across participants in terms of metabolically comparable phases (beginning, ventilatory threshold, VO2max) instead of percentages of maximal capacity.

Results. Pre‐to‐post‐exercise comparisons indicated affective benefits in the form of increased energetic arousal and decreased tense arousal. During exercise, however, affective valence deteriorated beyond the ventilatory threshold and until VO2max, a trend that reversed itself instantaneously during cool‐down.

Conclusions. Exercise intensity that requires a transition to anaerobic metabolism can have a transient but substantial negative impact on affect and this may, in turn, reduce adherence to exercise programmes.
Multidimensional fatigue, somatic symptoms and depression
Authors: Lavidor Michal , Weller Aron , Babkoff Harvey
Published: February 2003

Objectives. Assess the moderating role of somatization on depression in the perception of fatigue for a healthy adult population.

Design. Correlational survey.

Methods. Several fatigue questionnaires, a mental healthinventory, somatic complaints and demographic data were collected from a targeted, randomly selected adult sample (N = 278).

Results. Depression levels were positively and significantly related to all aspects of fatigue except fatigue that responds to rest and sleep (i.e. tiredness). When high levels of depression were coupled with somatization, fatigue complaints were more severe.

Conclusions. Even within a non‐patient population, somatization and depression had interactive effects on fatigue. Somatization increased fatigue level for the relatively dysphoric individuals.
Negative affect and binge eating in overweight women
Authors: Henderson Nicola J. , Huon Gail F.
Published: February 2003

Objectives. Binge eating among overweight women is associated with adverse physical and psychological consequences, and is known to occur in response to negative affect. This study sought to examine the role played by individual differences in coping style in the relationship between negative affect and binge eating.

Method. Overweight women (N = 105) completed a battery of questionnaires that assessed their binge eating severity, negative affect, and dispositional coping style.

Results. Women with higher levels of negative affect had more severe binge eating problems than those who generally experienced a low level of affective distress. Among those who were low in negative affect, however, those who tended to use the dysfunctional strategy of disengagement to cope with stress reported more severe binge eating than those who reported they were less likely to employ this coping style.

Conclusions. The findings from this study emphasize the complexity and multicausality of affect‐related binge eating in overweight women. Prospective studies are required to establish the role of negative affect and coping style in the onset and progression of recurrent binge eating among overweight individuals.
Exploring discontinuity patterns in the transtheoretical model: An application of the theory of planned behaviour
Authors: Armitage Christopher J. , Arden Madelynne A.
Published: February 2003

Objectives. The principal objective of the present paper was to investigate the utility of an extended theory of planned behaviour (TPB) for discriminating between stages of the transtheoretical model (TTM).

Design. Congruent with Sutton (2000) a cross‐sectional design was employed. The study (N = 331) investigated the TPB and TTM in the domain of health‐related food choice.

Method. The study utilized a questionnaire methodology. The data were analysed using analyses of variance and polynomial contrast analyses.

Results. Results showed a significant linear trend for all TPB variables across TTM stages, although there were significant quadratic relationships between TTM stage and both subjective norm and behavioural intention. Hierarchical regression analyses indicated that TTM stage might best be regarded as a proxy measure of behaviour.

Conclusions. The present study provides evidence to support the utility of the TPB but casts doubt on the TTM. Further research is required to evaluate the effectiveness of interventions targeted at individuals in certain stages with variables informed by the TPB, and to extend the present findings beyond the domain of health‐related food choice.
Psychological well‐being and quality of life in women with an iatrogenic hepatitis C virus infection
Authors: Coughlan Barbara , Sheehan John , Hickey Anne , Crowe John
Published: February 2003

Objective. This study documents psychological well‐being, mental health and quality of life in a group of women diagnosed with an iatrogenic hepatitis C (HCV) infection and examines the relationship between HCV RNA status and adjustment to their illness.

Design. A cross‐sectional design was used.

Method. Psychological well‐being, mental health and quality of life were assessed in a consecutive clinical sample of 93 women who were anti‐HCV positive (ELISA, third generation). Of these, 33 had a self‐limiting HCV infection (HCV RNA negative), whereas 60 had chronic HCVinfection(HCV RNA positive).

Results. Overall, psychological well‐being and mental health were diminished inall women and were best predicted by their level of social functioning, which accounted for between 42% and 57% of the variance. When comparing women with chronic HCV infection and those with a self‐limiting HCV infection, no differences were detected in quality of life and no association was found between HCV RNA status and a clinical diagnosis of depression or anxiety. Furthermore, no significant differences were demonstrated in HCV RNA positive women when compared according to liver histology on all measures.

Conclusion. In both HCV RNA positive and HCV RNA negative women, high levels of psychological distress and impaired quality of life were found. Impairments were not related to HCV RNA status or liver histology.
Children's concepts of illness: An intervention to improve knowledge
Authors: Williams Joanne M. , Binnie Lynne M.
Published: February 2003

Objectives: This study aimed to explore children's understanding of illness and attempted to improve their knowledge throughthe presentation of a factual story and group discussions.

Design: Children's responses to questions pertaining to three ailment types (contagious illness, non‐contagious illness and injury), for three process variables (cause, time from cause to effect, and recovery factors), were recorded before and after a training intervention.

Method: Children aged 4 (N=30) and 7 years old (N=30) were initially individually interviewed about common ailments(contagious: chickenpox and cold; non‐contagious: asthma and cancer; injury: scraped knee and broken arm). A week later half of the children in each age group (N=30) were included in a small group (N=5) intervention where factual information about three of the ailments was provided and children participated in guided group discussions. The remaining control children received no intervention. All children were subsequently individually interviewed a week later using the initial interview schedule.

Results: The 7‐year‐olds exhibited more sophisticated knowledge of illness at pre‐test than the 4‐year‐olds. Comparison of pre‐ to post‐intervention changes showed that children who participated in the intervention condition improved overall in their understanding of the ailments significantly more than controls. However, detailed analyses revealed a large degree of variation across the sample in terms of post‐test change for individual items.

Conclusion: Children's understanding of illness is complex and undergoes developmental changes between the ages of4 and 7. Educational interventions that provide age‐appropriate factual information and peer group discussions regarding illness processes might be effective in improving knowledge of illness among young children.
Influence of attention focus and trait anxiety on tolerance of acute pain
Authors: James Jack E. , Hardardottir Drifa
Published: February 2003

Objectives: In light of inconsistencies in the reported effects of attention and anxiety on pain tolerance, this study examined the separate and combined effects of attention focus and trait anxiety on tolerance of acute experimental pain.

Design: Participants with‘high’ and‘low’ trait anxiety were assigned to three attention‐focus conditions: pain‐focused attention,‘undirected’ (no experimenter‐induced attempts to influence attention focus) and distraction.

Methods: Several indices of autonomic arousal (systolic and diastolic blood pressure, heart rate and EMG) were measured before and during, and several self‐report inventories were completed before and after, each of two administrations ofthe cold pressor test.

Results: In general, pain tolerance was greater when participants were distracted and in low‐ rather than high‐anxiety participants. However, attention and anxiety interacted such that low‐anxiety participants were most pain tolerant, andhigh‐anxiety participants were least pain tolerant, in the undirected condition.

Conclusion: The results are consistent with the notion that anxiety fosters attentiveness to possible environmental threats, and might have implications for the clinical management of acute pain.
Combining motivational and volitional interventions to promote exercise participation: Protection motivation theory and implementation intentions
Authors: Milne Sarah , Orbell Sheina , Sheeran Paschal
Published: February 2003

Objective: This study compared a motivational intervention based on protection motivation theory (PMT, Rogers, 1975, 1983) with the same motivational intervention augmented by a volitional intervention based on implementation intentions (Gollwitzer, 1993).

Design: The study had a longitudinal design, involving three waves of data collection over a 2‐week period, incorporating an experimental manipulation of PMT variables at Time 1 and a volitional, implementation intention intervention at Time 2.

Method: Participants (N=248) were randomly allocated to a control group or one of two intervention groups. Cognitions and exercise behaviour were measured at three time‐points over a 2‐week period.

Results: The motivational intervention significantly increased threat and coping appraisal and intentions to engage in exercise but did not bring about a significant increase in subsequent exercise behaviour. In contrast, the combined protection motivation theory/implementation intention intervention had a dramatic effect on subsequent exercise behaviour. Thisvolitional intervention did not influence behavioural intention or any other motivational variables.

Conclusions: It is concluded that supplementing PMT with implementation intentions strengthens the ability of the model to explain behaviour. This has implications for health education programmes, which should aim to increase both participants' motivation and their volition.
A comparison of predictors of the adolescent intention to smoke with adolescent current smoking using discriminant function analysis
Authors: Mazanov J. , Byrne D. G.
Published: February 2003

Objectives: This paper explores one possible operationalization of smoking intention to assist development of adolescent smoking intervention programmes. Such programmes usually focus on predictors of current smoking, ignoring predictors of intentions to smoke, or how intentions relate to actual future smoking.

Design and method: Respondents took part in two stages of a repeated measures national survey on Australian adolescent smoking behaviour (12‐month interval between administrations). A total of N=1419 adolescents provided matched data, measuring personal smoking habits, intentions of smoking behaviour, stress (seven subscales), self‐esteem and response to the General Health Questionnaire (GHQ‐12).

Results: A comparison of discriminant function predictors showed similarity between the current smoking and intention to smoke, with only one predictor differing between the functions. Non‐smokers were more behaviourally consistent with their stated non‐smoking intention over 12 months (i.e. remain non‐smokers) than smokers (i.e. intention seemed unrelated to actual behaviour).

Conclusions: While the predictors give no general indication of whether the processes behind the intention to smoke differ from current smoking, the intention to smoke may be a better focus for intervention with smokers given the apparentinconsistency with stated intention. Intervention for non‐smokers may be usefully focused on maintaining non‐smoking ratherthan preventing smoking.