Rebound following failure to quit smoking: The effects of attributions and self-efficacy.

In this study the authors examined the process of rebound from failure, operationalized as a deliberate quit attempt within 6 months of failure in which the participant achieved at least 24 hr of abstinence, in a group of 63 smokers who failed to quit smoking. Guided, in part, by G. A. Marlatt and J. R. Gordon's (1985) abstinence violation effect model, the authors evaluated participants' reactions to failure by assessing causal attributions and self-efficacy immediately after the end of the failed quit effort and used these to predict rebound 3 and 6 months later in correlational and logistic regression analyses. Results showed that participants who rebounded attributed their prior failure to more unstable causes and had higher levels of self-efficacy following failure. Participants who rebounded also reported significantly more helpful attributional influences on their initial cessation effort. Logistic regression analyses indicated that more unstable reasons for failure to quit and helpful attributions moderately predict subsequent rebound. These effects are not mediated by self-efficacy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of feedback, casual attributions, and self-efficacy in goal revision.

An important issue in work motivation is how, when, and why individuals revise their goals up or down over time. In the current study, the authors examine feedback, causal attributions, and self-efficacy in this process. Although self-efficacy has frequently been suggested as a key explanatory variable for goal revision, its role has yet to be directly evaluated. Additionally, although attributions have been shown to influence goal revision following failure, the extent to which attributions influence goal revision following success remains unclear. In the current study, the authors address these issues by experimentally manipulating goal progress via performance feedback and tracking the resulting changes in self-efficacy and goal revision over time. In so doing, the authors also address several interpretive ambiguities present in the existing research. Results support the hypothesized model, finding that performance feedback and attributions interactively influenced self-efficacy, which in turn influenced goal revision. These results suggest that interventions targeting attributions, and self-efficacy more directly, may have meaningful influences on goal setting and pursuit, particularly following feedback. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship adjustment, depression, and anxiety during pregnancy and the postpartum period.

The associations between relationship adjustment and symptoms of depression and anxiety were evaluated in a sample of pregnant married or cohabiting women (N = 113) who were at risk for perinatal depression because of a prior history of major depression. Women completed self-report measures of relationship adjustment, depressive symptoms, and anxiety symptoms monthly during pregnancy and for the first six months following the birth of their child. Multilevel modeling was used to examine concurrent and time-lagged within-subjects effects for relationship adjustment and depressive and anxiety symptoms. Results revealed that (a) relationship adjustment was associated with both depressive symptoms and anxiety symptoms in concurrent analyses; (b) relationship adjustment was predictive of subsequent anxiety symptoms but not subsequent depressive symptoms in lagged analyses; and (c) depressive symptoms were predictive of subsequent relationship adjustment in lagged analyses with symptoms of depression and anxiety examined simultaneously. These results support the continued investigation into the cross-sectional and longitudinal associations between relationship functioning and depressive and anxiety symptoms in women during pregnancy and the postpartum period. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Effects of math self-concept, perceived self-efficacy, and attributions for failure and success on test anxiety.

Structural equation modeling was used to test a model of test anxiety. Variables in the model included gender, number of years since one's last math course, attributions for failure and success, math self-concept, perceived self-efficacy, achievement, general test anxiety, and statistical test anxiety. Failure and success attributions were found to influence general test anxiety and statistical test anxiety for both male and female students. Women who attributed success to behavioral causes were found to have higher levels of math self-concept than women attributing success to external causes. For men, those attributing failure to external causes were found to have higher levels of the worry component of statistical test anxiety. Math self-concept was negatively related to both general test anxiety and statistics test anxiety, whereas perceived self-efficacy had a negative relationship with the worry component of statistics anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between self-efficacy, attributions, and weight loss in a weight rehabilitation program.

Assessed the relationship between self-efficacy, attributions, and weight loss in the context of a weight rehabilitation program. Pretreatment, posttreatment, and followup assessments of self-efficacy, weight loss, and success–failure attributions were obtained from 38 volunteer overweight women (aged 21–65 yrs) participating in the program. Self-efficacy was significantly enhanced as a result of treatment, although it was not significantly related to weight loss during treatment. However, changes in efficacy expectations during follow-up did coincide with weight change during those intervals. In addition, efficacy expectations alone at treatment termination were found to be a significant predictor of weight loss following a 6-wk and 6-mo follow-up. Success–failure attributions contributed significantly to the prediction of efficacy expectations during treatment and during the 6-wk follow-up. Weight loss during treatment was not a significant determinant of treatment-induced self-efficacy enhancement. Results are interpreted in light of the reciprocal interaction between actual behavior change and cognitive factors in the context of a rehabilitation program. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specifying the determinants of the initiation and maintenance of behavior change: An examination of self-efficacy, satisfaction, and smoking cessation.

Using data from smokers (N = 591) who enrolled in an 8-week smoking cessation program and were then followed for 15 months, the authors tested the thesis that self-efficacy guides the decision to initiate smoking cessation but that satisfaction with the outcomes afforded by quitting guides the decision to maintain cessation. Measures of self-efficacy and satisfaction assessed at the end of the program, 2 months, and 9 months were used to predict quit status at 2, 9, and 15 months, respectively. At each point, participants were categorized as either initiators or maintainers on the basis of their pattern of cessation behavior. Across time, self-efficacy predicted future quit status for initiators, whereas satisfaction generally predicted future quit status for maintainers. Implications for models of behavior change and behavioral interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal smoking during pregnancy and childhood cancer

The association between maternal smoking during pregnancy and childhood cancer was investigated using prospectively collected data from 54,795 liveborn children in the Collaborative Perinatal Project (1959-1966). Cases of cancer had a histologic diagnosis and/or a compatible clinical course. There were 51 children with cancer, for a cumulative incidence of cancer of 1.1 per 1,000 by 96 months of age. Maternal smoking was determined at each prenatal visit; 52% of mothers reported smoking at one or more visits. By age 8 years, cancer had occurred in 1.4 per 1,000 children whose mothers did not smoke during pregnancy, compared with 0.9 per 1,000 children whose mothers smoked (p = 0.15 by log rank test); the hazard ratio was 0.67 (95% confidence interval (CI) 0.38-1.17). There was no dose-response effect of smoking compared with nonsmokers (hazard ratio for one to 10 cigarettes/day = 0.45, more than 10 cigarettes/day = 0.83). The hazard ratio for leukemia among children whose mothers smoked was 0.82 (95% CI 0.31-2.11); the hazard ratio for cancers other than leukemia was 0.60 (95% CI 0.30-1.20). Adjustment did not change the hazard ratio substantially. Although the relatively small number of cases precluded extensive study of individual types of cancer, the authors conclude that maternal smoking during pregnancy is not associated with an increased risk of childhood cancer in this cohort.     

Maternal smoking during pregnancy, growth, and bone mass in prepubertal children

OBJECTIVES: A long-term follow-up study with nuclear magnetic resonance (NMR) imaging was undertaken to detect the morphological onset and to establish the early diagnosis in apical hypertrophic cardiomyopathy (HCM). BACKGROUND: A spadelike configuration on left ventriculogram (LVG) is regarded as a diagnostic criterion for the classical apical HCM. There also exists a segmented hypertrophy at the apical level without indicating the spadelike features (a nonspade configuration). To detect the hypertrophied myocardium of the nonspade configuration, circumferential scrutiny of the apex is required. Although both configurations can be underlying causes of giant negative T waves, etiological relationship between the two is not clarified. METHODS: The criteria for the spadelike configuration defined on left ventricular short-axis NMR images were as follows: (apical maximal thickness > or = 15 mm), (apical anterior thickness over basal anterior thickness > or = 1.3) and (apical posterior thickness over basal posterior thickness > or =1.3). Thirteen patients who had predominant hypertrophy (> or = 15 mm) at the apical level without the spadelike configuration underwent NMR imaging twice before and after 54+/-10 months' follow-up. RESULTS: Apical hypertrophy that had been confined to the lateral wall in four, the anterior-lateral wall in two, and the septal-anterior wall in one developed to become circumferential hypertrophy that fulfilled the criteria for the spadelike configuration after the follow-up period. CONCLUSIONS: The spadelike configuration can begin with the nonspade configuration and therefore, both can constitute a single disease entity of apical HCM. The early diagnosis of apical HCM can be achieved by identifying the hypertrophy frequently confined to the lateral wall at the apical level.     

Dynamic effects of self-efficacy on smoking lapse and relapse.

Self-efficacy (SE) is thought to be critical to success in smoking cessation both as an individual difference and as a dynamic process after a quit attempt. In this study, 214 smokers used palm-top computers to record day-to-day variations in SE during 4 weeks after quitting. SE remained at high and stable levels prior to a 1st lapse but decreased and became more variable thereafter. The authors used event history models with time-varying covariates to assess the effect of daily SE on lapse and relapse risk. Daily SE measures predicted an initial lapse on the subsequent day. However, this relationship was accounted for by stable baseline differences in SE (assessed by questionnaire), rather than by day-to-day dynamics in SE. Progression from 1st lapse to relapse was also examined. In this instance, daily SE predicted subsequent relapse risk, even when baseline SE and concurrent smoking were accounted for, suggesting the importance of SE dynamics for this stage of the relapse process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contextual correlates of adolescents' self-efficacy after smoking cessation.

Recent research has shown that daily changes in self-efficacy predict lapses and relapse into smoking after quitting among adolescent daily smokers, but it is not known if and how momentary self-efficacy is associated with affect-motivational states and external contexts. In the present study, 134 adolescent daily smokers were monitored daily during 1 week prior to and 3 weeks after they began their quit attempt. Participants completed questions on smoking, self-efficacy, affect-motivational states (craving and negative affect), and external contexts (seeing others smoke, experiencing a stressful event, and alcohol and coffee consumption) three times a day. Affect-motivational states as well as all external contexts (except for coffee consumption) were associated with lower self-efficacy when participants were still abstinent, but also after they had lapsed. Associations between the situational contexts and self-efficacy did not largely depend on individual characteristics such as baseline self-efficacy and age. Among girls, however, the negative associations between self-efficacy and negative affect and drinking alcohol were found to be stronger. These results show that adolescents' self-efficacy during a quit attempt may be responsive to affect-motivational states and external contexts, both before and after lapsing. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Social support and smoking cessation and maintenance.

Examined the role of social support in smoking cessation and maintenance in 2 longitudinal, prospective studies with 64 Ss each (mean ages 38.4 yrs and 38.8 yrs). Three kinds of support factors were assessed: support from a partner directly related to quitting, perceptions of the availability of general (i.e., nonsmoking) support resources, and the presence of smokers in Ss' social networks. Ss were smokers in cessation programs. Corroborated smoking status was obtained through 12 mo posttreatment. There was evidence for all 3 support factors, but they operated at different points in the process of cessation and maintenance. High levels of partner support and of the perceived availability of general support were associated with cessation and with short-term (to 3 mo posttreatment) maintenance of abstinence. The presence of smokers in Ss' social networks was a hindrance to maintenance and significantly differentiated between relapsers and long-term (12-mo) abstainers. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in cervical fibronectin levels during pregnancy, labor and in the postpartum period

The authors analysed the fibronectin content of the uterine cervix during pregnancy and delivery. The aim of their investigation was furnishing data to the biochemical changes during cervical maturation. The ripening of the uterine cervix during pregnancy is a result of complicated interactions between different macromolecules, where the fibronectin plays a key role. The quantitative determination of the extracellular matrix fibronectin is impossible because its extraction from tissues recently is not solved. Taking this fact in consideration the authors choose a semiquantitative method, being reliable indicator of changes in fibronectin content of uterine cervix. They took small pieces of materials from portio vaginalis uteri of 139 women being in postmenopause and premenopause, in different stages of pregnancy and parturition concerning directly after delivery. The slides were incubated, with rabbit-anti-human fibronectin-FITC. The evaluation of fluorescence happened with an Axiophot (Zeiss) microscope. Authors stated that the fibronectin content in the cervical extracellular matrix and in the cellular membrane of fibroblasts increases during the 1st trimester pregnancy. This increase can be shown in the 3rd trimester as well and it drops significantly during delivery. They could not found any relationship between the leucocyte invasion observed during delivery and the changes of cervical fibronectin content. These observations call our attention to the importance of fibronectin in cervical ripening respectively dilatation and the need of further examinations.     

Causal attributions in paranoia and depression: Internal, personal, and situational attributions for negative events.

Causal attributions for positive and negative hypothetical social events made by paranoid patients, depressed patients, and nonpatient participants were examined via a novel measure of causal locus, the Internal, Personal and Situational Attributions Questionnaire. Depressed patients tended to attribute negative social events to internal (self-blaming) causes. Nonpatient participants and patients with delusions of persecution tended to avoid such self-blame. However, whereas nonpatient participants tended to choose situational or circumstantial external attributions, paranoid patients tended to choose external attributions that located blame in other individuals. These findings support R. P. Bentall, P. Kinderman, and S. Kaney's (1994) defensive attributional model of persecutory delusions, suggest some modifications to that model, and have implications for the understanding of the relationship between causal attributions and social and self-perception. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pros and cons of quitting, self-efficacy, and the stages of change in smoking cessation.

In The Netherlands, 34% of the population smoke, and 70% of these smokers are not planning to quit. The lower percentages in the U.S. population seem to reflect a difference in smoking culture. This study analyzes the pros and cons of quitting and self-efficacy expectation in the 5 stages of change in the Dutch population. The results are compared with the pattern of the pros and cons of smoking and self-efficacy expectations found in U.S. samples. The data show the hypothesized pattern: In the first 2 stages, the expected positive outcomes of quitting discriminated better between the stages than self-efficacy, whereas for later stages, self-efficacy was the better discriminator. This study shows that the stage typology is applicable to the Dutch population and that the pattern of the pros, cons, and self-efficacy is very similar to the pattern found in the U.S. populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perinatal events associated with maternal smoking during pregnancy

To identify components of smoking-related increased perinatal mortality, detailed analyses of data from the Ontario Perinatal Mortality Study (50,000 births, 1,300 deaths, 1960-1961) measured the relationship of maternal smoking to birth weight, gestation, placental complications, and perinatal mortality. Cross-tabulations with other factors and multiple adjustment showed increases with amount smoked of birth weights less than 2500 gm, gestations less than 38 weeks, placenta previa, abruptio placentae, and perinatal mortality. These significant, smoking-related increases were independent of mother's height, weight, hospital status, age-parity group, birthplace, previous pregnancy history, weight gain, time of registration, and sex of child. Maternal smoking had the strongest effect on birthweight in the 8 factor regression, and birth less than 2500 gm increased directly with smoking level from 20% to 340% in 37 data subgroups. Births less than 38 weeks increased 20% and 50% and perinatal mortality increased 20% and 35% for less than 1 pack and 1 + pack smokers, respectively, adjusted for 7 other factors. Placental complications increased consistently with smoking level in all of 37 subgroups except for primiparous less than 1 pack smokers. Adjusted rates increased 25% and 92% for placenta previa, 23% and 86% for abruptions among smokers of less than 1 pack and 1 + packs, respectively. These complications carry high perinatal mortality risk, and account for one-third to one-half of the perinatal deaths attributable to maternal smoking.     

Maternal smoking during pregnancy and psychiatric adjustment in late adolescence

Large-core (14g) needle biopsy (CNB) of the breast is a new diagnostic modality increasingly being used to evaluate patients with mammographic abnormalities. Two hundred twenty-four CNBs were performed on 198 patients. Surgical follow-up was available in 64 cases (28.6%). Overall concordance rate was 93.8% (60 of 64 cases). Of the four discordant cases, two were diagnosed as atypical ductal hyperplasia (ADH) on CNB; on excision, these cases showed cribriform ductal carcinoma in situ (DCIS); two remaining cases, diagnosed on CNB as ADH versus DCIS, showed invasive carcinoma (DCIS with invasive component and infiltrating cribriform carcinoma, respectively) on excisional biopsy. Malignancy, primary (52) or metastatic (5), was identified in 57 cases (25.4%); 47 of these patients underwent surgical excision, and the diagnosis was confirmed in all of these cases. Of 51 cases with radiographic evidence of microcalcifications, 48 (94%) had microcalcifications in the CNB: 30 (62.5%) were benign, 11 (22.9%) were malignant, and 7 (14.6%) were diagnosed as ADH. In the remaining three cases (1.3%), only benign breast tissue without microcalcifications was seen, and the lesion was considered to have been missed. Biopsy specimens were obtained from 173 lesions because of the presence of a mass: 125 (72.3%) were benign, 45 (26%) were malignant, and 3 (1.7%) were diagnosed as ADH. Follow-up was available in 118 patients with benign lesions: all were mammographically stable or decreased at 6 or 12 months; no follow-up was available for the remaining patients. CNB of the breast is a highly sensitive (96.9%) and specific (100%) technique for management of patients with mammographic abnormalities. The histologic findings should be correlated with the mammographic appearance, and an attempt should be made to achieve a specific diagnosis in all lesions, particularly masses. The diagnosis of ADH should always prompt excisional biopsy because of a high frequency of false-negative results caused by sampling errors or underestimation.     

Dynamic effects of self-efficacy on smoking lapses and relapse among adolescents.

Objective: The present study examined whether dynamic day-to-day variations in self-efficacy predicted success in quit attempts among daily smoking adolescents. Design: A sample of 149 adolescents recorded their smoking and self-efficacy three times per day during 1 week prior to and 3 weeks after a quit attempt. Main Outcome Measures: The first lapse, second lapse, and relapse after at least 24 hours of abstinence from smoking were the main outcome measures. Results: Self-efficacy was relatively high and moderately variable prior to the first lapse, but decreased and became more variable thereafter. Lower self-efficacy as measured at the lapse assessment significantly increased the risk that a second lapse and relapse would occur. Individual differences in baseline self-efficacy did not predict any of the treatment outcomes. The time-varying analyses, however, showed that lower self-efficacy on a given day predicted the first lapse, the second lapse, and relapse on the succeeding day. Daily concomitant smoking (any smoking on the preceding day) was not significantly related to relapse. Conclusion: The present results emphasize the importance of self-efficacy among adolescents in cessation and highlight the need for dynamic formulations and assessments of adolescents' self-efficacy and relapse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)