Health Psychology

Presseau, Justin; Tait, Richard I.; Johnston, Derek W.; Francis, Jill J.; Sniehotta, Falko F.

doi: 10.1037/a0029430pmid: 22888818

Objective: To test whether perceptions of conflicting and facilitating personal goals, and actual daily time spent in their pursuit, predict accelerometer-assessed physical activity (PA). Methods: A prospective multilevel design with a daily accelerometer-based assessment of PA over 1 week was used (N = 106). Participants’ personal goals were elicited using personal projects analysis. Participants then rated their personal goals in terms of how they were perceived to facilitate and conflict with their regular PA. Items assessing PA-specific intention and perceived behavioral control (PBC) were also embedded within the baseline measures. For the subsequent 7 consecutive days, participants completed a daily diary based on the day reconstruction method, indicating the time spent in daily episodes involving each of their personal goals, and wore an RT3 tri-axial accelerometer. Main Outcome Measure: The main outcome was accelerometer-assessed daily time spent in moderate to vigorous physical activity (MVPA). Results: Random intercept multilevel models indicated that perceived goal facilitation, but not perceived goal conflict, predicted MVPA over and above intention and PBC. Daily time pursuing conflicting goals negatively predicted MVPA when subsequently added to the model and in so doing, attenuated the association between perceived goal facilitation and MVPA. Conclusion: Perceived goal facilitation predicts objectively measured PA over and above intention and PBC, but daily time spent in pursuit of conflicting personal goals provides a better account of how alternative goals relate to engaging in regular PA.

Bassett-Gunter, Rebecca L.; Martin Ginis, Kathleen A.; Latimer-Cheung, Amy E.

doi: 10.1037/a0030126pmid: 23088175

Objective: The primary purpose was to examine the relative effectiveness of chronic disease and psychological health risk information combined with gain- versus loss- framed leisure time physical activity (LTPA) messages for changing perceived personal risk, LTPA response efficacy (i.e., the belief that LTPA can effectively reduce risk), and LTPA intentions. A secondary purpose was to explore the relationship between message framing and cognitive processing. Method: Baseline assessments of perceived risk for inactivity-related disease and psychological health problems, LTPA response efficacy, and intentions were measured among 96 individuals with spinal cord injury (SCI). Participants read population-specific information about the risk for inactivity-related disease and psychological health problems following SCI, and perceived risk was reassessed. Participants were then randomized to read LTPA response efficacy messages emphasizing the benefits of LTPA (gain framed) or the risks of inactivity (loss framed). Immediately following message exposure, cognitive processing (i.e., thought listing and message recall), LTPA response efficacy, and LTPA intentions were assessed. Results: Changes in perceived risk were observed following exposure to health risk information. Changes in LTPA response efficacy and intentions were greater following loss-framed messages targeting psychological health compared with gain-framed messages. Greater cognitive processing was observed following loss-framed messages compared with gain-framed messages. Conclusion: Following exposure to psychological health risk information, loss-framed messages may be more effective than gain-framed messages for eliciting cognitive processing and changing LTPA beliefs and intentions.

Brown, Linda F.; Rand, Kevin L.; Bigatti, Silvia M.; Stewart, Jesse C.; Theobald, Dale E.; Wu, Jingwei; Kroenke, Kurt

doi: 10.1037/a0029773pmid: 22924447

Objective: Fatigue is one of the most common and debilitating symptoms reported by cancer patients, yet relatively little is understood about its etiology. Recently, as researchers have begun to focus attention on cancer-related fatigue (CRF), depression has emerged as its strongest correlate. Few longitudinal studies, however, have examined directionality of the relationship between the two symptoms. Our aim was to evaluate the directionality of the association between depression and CRF. Method: The study used a single-group cohort design of longitudinal data (N = 329) from a randomized controlled trial of an intervention for pain and depression in a heterogeneous sample of cancer patients. Participants met criteria for clinically significant pain and/or depression. Our hypothesis that depression would predict change in fatigue over 3 months was tested using latent variable cross-lagged panel analysis. Results: Depressive symptoms and fatigue were strongly correlated in the sample (baseline correlation of latent variables = 0.71). Although the model showed good fit to the data, χ2 (66, N = 329) = 88.16, p = .04, SRMR = 0.030, RMSEA = 0.032, and CFI = 1.00, neither structural path linking depression and fatigue was significant, suggesting neither symptom preceded and predicted the other. Conclusions: Our findings did not support hypotheses regarding the directionality of the relationship between depressive symptoms and fatigue. The clinical implication is that depression-specific treatments may not be sufficient to treat CRF and that instead, interventions specifically targeting fatigue are needed.

Baldwin, Austin S.; Rothman, Alexander J.; Vander Weg, Mark W.; Christensen, Alan J.

doi: 10.1037/a0029937pmid: 23025303

Objective: Self-persuasion—generating one’s own arguments for engaging in a specific behavior—can be an effective strategy to promote health behavior change, yet the causal processes that explain why it is effective are not well-specified. We sought to elucidate specific causal components and a mediating process of self-persuasion in two health behavior domains: physical activity and smoking. Methods: In two experiments, participants were randomized to write or read arguments about regular exercise (Study 1: N = 76; college students) or smoking cessation (Study 2: N = 107; daily smokers). In Study 2, we also manipulated the argument content (matched vs. mismatched participants’ own concerns about smoking) to isolate its effect from the effect of argument source (self vs. other). Study outcomes included participants’ reports of argument ratings, attitudes, behavioral intentions (Studies 1 & 2), and cessation attempts at 1 month (Study 2). Results: In Study 1, self-generated arguments about exercise were evaluated more positively than other arguments (p = .01, d = .63), and this biased processing mediated the self-generated argument effect on attitudes toward exercise (β = .08, 95% CI = .01, .18). In Study 2, the findings suggested that biased processing occurs because self-generated argument content matches people’s own health concerns and not because of the argument source (self vs. other). In addition, self-generated arguments indirectly led to greater behavior change intentions (Studies 1 & 2) and a greater likelihood of a smoking cessation attempt (Study 2). Conclusions: The findings elucidate a causal component and a mediating process that explain why self-persuasion and related behavior change interventions, such as motivational interviewing, are effective. Findings also suggest that self-generated arguments may be an efficient way to deliver message interventions aimed at changing health behaviors.

Gilts, Chelsea D.; Parker, Patricia A.; Pettaway, Curtis A.; Cohen, Lorenzo

doi: 10.1037/a0030189pmid: 23088178

Objective: It is important to identify factors that predict who will benefit the most from psychosocial interventions in cancer populations. Methods: This study examines the moderating effect of baseline social support (social support, SS; dyadic adjustment DA), distress (Brief Symptom Inventory, BSI; Impact of Event Scale, IES), and coping style (Brief COPE) on quality of life outcomes (SF-36 Physical Component Summary scores, PCS) 1 year postsurgery derived from a presurgical cognitive–behavioral stress management (SM; n = 23) program, supportive attention (SA; n = 37), or standard care (SC; n = 29). Results: Moderation analyses indicated that men who reported low SS and were in the SM group had increased PCS 1 year after surgery as compared with men with low SS in the SC group (β = −0.39, p < .01), with SA having a nonsignificant intermediate effect. Men who reported high distress (BSI) at baseline and were in the SA group had increased PCS 1 year after surgery, as compared with those in the SC group (β = 24.80, p = .01), with SM having a nonsignificant intermediate effect. Mediation analyses suggested that neither SM nor SA improved quality of life simply by increasing social support or decreasing general distress. Conclusions: Distressed individuals may benefit more from unstructured discussion of distress, whereas those low in social support may benefit more from a structured approach to learning coping skills.

Gallagher, Patrick; Yancy, William S.; Denissen, Jaap J. A.; Kühnel, Anja; Voils, Corrine I.

doi: 10.1037/a0029956pmid: 23025299

Objective: Previous studies examining correlates of leisure time physical activity (LTPA) have identified personality factors that are correlated with LTPA and practical factors that impede LTPA. The purpose of the present study was to test how several narrow traits predict daily reports of LTPA and to test whether traits that predict LTPA moderate the effects of practical barriers. Methods: 1192 participants completed baseline measures of personality, then reported their LTPA and several situational and environmental factors daily for 25 days. We used generalized estimating equations to measure how personality traits, practical barriers, and interactions between these factors affected (1) the odds of engaging in LTPA and (2) the duration of daily LTPA. Results: Higher standing on Activity and Discipline and lower standing on Assertiveness predicted greater odds of engaging in LTPA and longer duration of LTPA, and higher standing on Aesthetics predicted shorter duration of LTPA. Poor weather conditions and less leisure time were associated with less LTPA, and effects of these barriers were generally greater among participants 30 and older. In participants older than 30, poor weather was associated with less LTPA among those with lower standing on Activity but was not associated with LTPA among those high in Activity. Despite Discipline’s overall positive association with LTPA, less leisure time and less routineness were greater barriers for those high in Discipline. Conclusions: Assessing narrow personality traits could help target LTPA interventions to individual patients’ needs and could help identify important new personality dynamics that affect LTPA.

Eisenlohr-Moul, Tory A.; Burris, Jessica L.; Evans, Daniel R.

doi: 10.1037/a0030150pmid: 23088173

Objective: A growing body of evidence suggests that chronic pain patients suffer from chronic self-regulatory fatigue: difficulty controlling thoughts, emotions, and behavior. Pain acceptance, which involves responding to pain and related experiences without attempts to control or avoid them (pain willingness), and pursuit of valued life activities regardless of pain (activity engagement) has been associated with various favorable outcomes in chronic pain patients, including better psychological functioning. The study presented here tested the hypotheses that pain acceptance is associated with less psychological distress, higher psychological well-being, and reduced self-regulatory fatigue in temporomandibular disorder (TMD) patients, particularly for those with longer pain duration. Methods: Cross-sectional data were provided by 135 TMD patients during an initial evaluation at a university-based tertiary orofacial pain clinic. Results: Results of hierarchical linear regression models indicated that, controlling for pain severity, pain willingness is associated with less psychological distress and lower self-regulatory fatigue, and activity engagement is associated with greater psychological well-being. Furthermore, the effect of pain willingness on psychological distress was moderated by pain duration such that pain willingness was more strongly associated with less psychological distress in patients with longer pain duration; this moderating effect was fully mediated by self-regulatory fatigue. Conclusion: These findings suggest pain willingness may buffer against self-regulatory fatigue in those with longer pain duration, and such conservation of self-regulatory resources may protect against psychological symptoms.

Dunlop, William L.; Falk, Carl F.; Beauchamp, Mark R.

doi: 10.1037/a0030412pmid: 23106111

Objective: Within exercise class settings, group cohesion has consistently been found to predict adherence behaviors, and has been identified as a salient target for intervention-based initiatives. Drawing upon theorizing from the field of group dynamics, exercise class cohesion is often conceptualized as a dynamic construct that requires several classes to form and once it is formed, continues to change over time. Despite the salience of this “dynamic” contention for informing physical activity interventions, this theorizing has yet to be empirically tested. Method: In this study a multilevel modeling framework was used to examine changes in exercise class cohesion over time. Exercisers (N = 395) completed measures of cohesion following the second, fifth, and eighth classes of their respective programs (N = 46). Results: Mean levels of social cohesion changed significantly over time whereas mean levels of task cohesion did not. These patterns were largely consistent across persons and groups. Conclusions: These findings suggest that within group-based exercise programs social and task cohesion possesses different levels of dynamism, and that this dynamism (or lack thereof) might have important implications for future research and interventions involving physical activity groups.