Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes.

Tested a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N?=?362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model—largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A contextual cognitive-behavioral analysis of rehabilitation workers' health and well-being: Influences of acceptance, mindfulness, and values-based action.

Purpose: Rehabilitation settings can be extremely demanding, and sometimes stressful, places to work. It is important, therefore, to consider influences on rehabilitation workers' health and general well-being and on their ability to face emotional, physical, or mental challenges at work. The purpose of this study was to examine a set of psychological processes, including psychological acceptance, mindfulness, and values-based action, that may be relevant to this problem. Method: Ninety-eight rehabilitation workers at the Rehabilitation Centre, Tan Tock Seng Hospital, Singapore, completed measures of background variables, health, and functioning, in addition to the 3 psychological variables of primary interest. Results: Correlation analyses demonstrated significant relations of the acceptance, mindfulness, and values measures with the measures of stress, burnout symptoms, health, and well-being, particularly general health perception, vitality, social functioning, and emotional functioning. In regression analyses, the process variables accounted for significant, and in some cases practically meaningful, increments in explained variance in 10 key outcomes related to work experience and health. Conclusion: Acceptance, mindfulness, and values-based action deserve further consideration in relation to burnout, health, and well-being among rehabilitation workers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol treatment changes in coping skills, self-efficacy, and levels of alcohol use and related problems 1 year following treatment initiation.

The relationships among alcohol treatment, coping skills, and self-efficacy in predicting alcohol use and related consequences following treatment initiation were investigated. The participants were 77 men and 65 women who were entering either inpatient or outpatient alcohol treatment. The analyses confirmed predictions that treatment, coping skills, and self-efficacy each contributed significantly to the prediction of 12-month alcohol consumption beyond the variance accounted for by participant control variables. Only self-efficacy explained significant additional variance in the consequences outcome. Mediation analyses of the alcohol consumption variables suggested that treatment effects were not mediated by either coping skills or self-efficacy and that the effects of coping skills were not mediated by self-efficacy. The findings are interpreted as providing partial support for social learning theory approaches. Suggestions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress-related growth, positive reframing, and emotional processing in the prediction of post-trauma functioning among veterans in mental health treatment.

The role of stress related growth (SRG) in posttrauma functioning is currently uncertain and may be obscured by the overlap between SRG and key coping strategies. Utilizing a veteran sample in mental health treatment, the current study examined whether SRG accounts for unique variance in the severity of posttraumatic stress disorder (PTSD), depression, and Disorders of Extreme Stress Not Otherwise Specified (DESNOS) beyond the effects of two general coping strategies, emotional processing and positive reframing. Curvilinear relationships were evident between SRG and outcome measures, such that individuals with moderate SRG reported the greatest distress, and individuals with the lowest and highest SRG scores reported lower distress. In regression analyses, SRG accounted for significant variance in lower PTSD, depression, and DESNOS while accounting for demographics, trauma type, emotional processing, and positive reframing. The results suggest that SRG captures variance in posttrauma functioning that may be distinct from general emotional processing and positive reframing coping and provides further evidence for a curvilinear relationship between SRG and measures of psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term follow-up of physical activity behavior in older adults.

Objective: To examine the contribution of social-cognitive factors (self-efficacy and affect) in predicting long-term physical activity in a sample of older adults (N = 174). Design: A prospective design assessed physical activity and psychosocial variables at 2 and 5 years following a 6-month randomized, controlled exercise trial. Main Outcome Measures: The primary outcome variable was self-reported physical activity, with previous behavior, self-efficacy, and affect assessed as determinants of physical activity. Results: Covariance modeling analyses indicated that physical activity at Year 2 was the strongest predictor of physical activity at 5-year follow-up. Both self-efficacy and affect at Year 2 were also associated with physical activity at Year 5, as was original treatment condition. Variables accounted for 35% of the variance in Year 5 activity. Conclusion: Older adults with higher levels of physical activity, more positive affect, and higher self-efficacy at Year 2 were more likely to continue to be active at Year 5. This study is one of the longest follow-ups of exercise behavior in older adults and has implications for structuring environments to maximize the maintenance of physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hope, self-efficacy, and functional recovery after knee and hip replacement surgery.

Objective: To test hypothesized relations between hope and self-efficacy for rehabilitation to depression and functional ability reported by individuals receiving joint replacement surgery. Study Design: Community-dwelling older adults (N = 100) from an orthopaedic clinic were administered measures of hope, self-efficacy for rehabilitation, pain, depression, body mass index (BDI), and mental status 1 month prior to their joint replacement surgery. These measures were completed by 62 participants 6 weeks after surgery. Demographic, health information, and functional outcome measures were obtained by medical personnel pre- and postsurgery. Main Outcome Measures: Functional outcome measures (Harris Hip and Knee Society Scores) and depressive symptomatology. Results: Hope was significantly predictive of presurgery depression, but it was not predictive of depression or functional ability after surgery. Higher levels of self-efficacy were predictive of lower postsurgery depression scores. Conclusions: Results imply that social-cognitive constructs may have utility in the prediction of emotional adjustment before and after joint surgery, but they may have limited value in anticipating functional abilities following these surgeries. Theoretical and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health promotion for women with physical disabilities: A pilot study.

Objective: To pilot test a health promotion intervention for women with physical disabilities. Design: Pre- and postintervention questionnaires. Participants: Two groups of women with physical disabilities (n=15). Intervention: Seven-session weekly workshop intervention grounded primarily in social-cognitive theory. Setting: Disability and rehabilitation settings. Main Outcome Measures: Indicators of health status. Results: Statistically significant positive changes between pre- and postintervention scores on measures of self-efficacy for dietary behaviors, medical decision making, social interaction, physical functioning, impact of physical limitation on role activities, and vitality. Conclusion: Women with disabilities who participate in this health promotion intervention may exhibit improvements on indicators of health status. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding health outcomes: Physical secondary conditions in people with spinal cord injury.

Objective: To examine the association of predisposing characteristics and enabling characteristics with physical secondary conditions through health practices and health care use in people with spinal cord injury (SCI). Design: Cross-sectional survey mailed to adults in portions of the northeastern and northwestern United States. Participants: Two hundred seventy adults with SCI recruited through durable medical equipment supply companies. Main Outcome Measures: Self-reported health practices, health care use, and physical secondary conditions. Results: In the Andersen behavioral model, F increment tests supported findings that predisposing characteristics accounted for 12% of variance in secondary conditions, enabling characteristics accounted for 16%, and health practices and health care use accounted for another 13%. Path analysis revealed that health care use mediated self-efficacy and interpersonal support. Conclusions: Predisposing characteristics including self-efficacy, enabling characteristics, and health care use are associated with physical secondary conditions in complex ways. More research is needed on measures of health practices and their relation to secondary conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social-cognitive determinants of physical activity: The influence of social support, self-efficacy, outcome expectations, and self-regulation among participants in a church-based health promotion study.

A social-cognitive model of physical activity was tested, using structural equation analysis of data from 999 adults (21% African American; 66% female; 38% inactive) recruited from 14 southwestern Virginia churches participating in the baseline phase of a health promotion study. Within the model, age, race, social support, self-efficacy, and self-regulation contributed to participants' physical activity levels, but outcome expectations did not. Of the social-cognitive variables, self-regulation exerted the strongest effect on physical activity. Independent of self-regulation, self-efficacy had little effect. Social support influenced physical activity as a direct precursor to self-efficacy and self-regulation. The model provided a good fit to the data and explained 46% of the variance in physical activity among the diverse group of adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term relations between intentions, planning, and exercise: A 3-year longitudinal study after orthopedic rehabilitation.

Objective: Planning has been hypothesized to operate as a mediator linking intentions to health behaviors. To explore the temporal variation of these constructs and their interrelationships, a long-term study of intentions, planning, and physical activity was conducted. Method: A sample of 328 individuals in orthopedic rehabilitation provided data at five measurement occasions over 3 years after their discharge from rehabilitation. A process-oriented approach combining mediation analysis and latent growth curve (LGC) modeling was applied. Results: The orthopedic rehabilitation led to an initial increase in planning and behavior, followed by a decrease after 6 months and stabilization for the next 2.5 years. Intention revealed a slight but constant decrease for 6 months and remained stable up to 3 years after rehabilitation. The mediation model confirmed planning as mediator between intention and physical activity in former rehabilitation participants. Conclusions: Prior evidence on the mediating role of planning in the intention-behavior relation is corroborated and extended by the present findings at the level of long-term processes. Planning can and should be integrated in rehabilitation treatment programs to facilitate sustainable recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood abuse and current health problems among older adults: The mediating role of self-efficacy.

Objectives: Child abuse has negative consequences on health functioning and the self-concept. Prior studies have garnered support for these relationships in younger adults; yet few studies have looked at the effects of abuse on health in older adults and the psychosocial variables, specifically self-efficacy, that may influence the abuse-health relationship. Methods: Data obtained from the Physical Health and Disability Study were used to explore the impact of child abuse on current medical problems among older adults who were screened on physical disability status (N = 1396, Mean age = 67, SD = 10.2). The study was conducted in South Florida and used a multiethnic sample that is representative of the general population in this area. Results: Child abuse was associated with the number of current medical problems and disability. Child abuse was also related to lower self-efficacy, and self-efficacy explained the relationship between abuse and the number of health problems. Conclusions: There are far-reaching effects of child abuse on older adults' health and self-concept. Health care providers and gerontologists need to be aware that child abuse is a lifelong risk factor for increased disability and specific health problems, especially among the elderly. Future research should examine treatments designed to increase self-efficacy, especially among those who experienced child abuse, and observe any positive effects on health functioning. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The relation of acculturation, problem-solving appraisal, and career decision-making self-efficacy to Mexican American high school students' educational goals.

This study examined the contributions of acculturation, problem-solving appraisal, and career decision-making self-efficacy on 105 Mexican American high school students' educational goals. A standard regression analysis indicated that Anglo-oriented acculturation and problem-solving appraisal accounted for significant variance in educational goals. Mexican-oriented acculturation and career decision-making self-efficacy did not contribute significant variance to students' educational goals. The regression model accounted for 19.5% of the variance in educational goals. Results of the structure coefficients for the predictor variables indicated that Anglo-oriented acculturation and career decision-making self-efficacy were the 2 most important predictors, followed by problem-solving appraisal and Mexican-oriented acculturation, respectively. Implications of the findings are discussed, and recommendations for interventions are provided for enhancing the educational and career development among Mexican American adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonpsychiatric medical comorbidity, health perceptions, and treatment outcome in patients with panic disorder.

Panic disorder is frequently complicated by high rates of co-occurring nonpsychiatric medical conditions. The present study examined the relationship between medical morbidity, perceived physical health, and treatment outcome in panic disorder Patients meeting the American Psychiatric Association's Diagnostic and Statistical Manual of mental disorders (1994) criteria for panic disorder (N?=?71) completed 12 sessions of cognitive-behavioral treatment and were assessed at posttreatment and 6-month follow-up. Medical comorbidity and perceived health were both found to be related to end-state functioning. Medical comorbidity did not uniquely predict outcome beyond its shared variance with perceived health. At posttreatment, 71% of patients who perceived their physical health as good met recovery criteria compared with only 35% of those who perceived their health as poor. At follow-up, 67% of those who perceived their physical health as good met composite recovery criteria compared with only 33% of those with perceived poor health. These findings offer preliminary support for the impact of physical health, both actual and perceived, on treatment outcome of patients with panic disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants of health knowledge: An investigation of age, gender, abilities, personality, and interests.

Ten areas of health knowledge were investigated in 2 studies, 1 of college students (N=169) and 1 of adults from the community (ages 19-70; N=176). Measures assessed knowledge of aging, orthopedic/ dermatological concerns, common illnesses, childhood/early life, serious illnesses, mental health, nutrition, reproduction, safety, and treatment of illness/disease. Significant gender differences favoring women were found for most areas of health knowledge, especially reproduction and early life. Results showed that cognitive ability accounted for the most variance in health knowledge with nonability (personality and interest traits) and demographic variables accounting for smaller but significant amounts of variance across most knowledge domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Related factors contributing to the healthy lifestyle of urban employees through the PRECEDE model

The purpose of this study was to assess the related factors to the healthy lifestyle of 1147 urban employees. The theoretical framework of this study was the PRECEDE model. The model included three factors: 1. predisposing factors cardiovascular disease knowledge, general self-efficacy, health related diet and exercise self-efficacy, attitude for maintaining healthy life-style, health value, health status and illness history of family); 2. enabling factors (health resource availability, health resource utility); and 3. reinforcing factors (social support, feelings of colleagues health practice); The three factors were measured by 12 scales, through which the reliability and validity were assessed. According to the stepwise multiple regression analysis, diet and exercise self-efficacy, attitude for maintaining healthy life-style, marital status, cardiovascular disease knowledge, health status, occupational level, social support and feel of colleague health practice were the significant factors which accounted for 38.2% of variance. Predisposing factors and reinforcing factors were the important factors of healthy lifestyle on urban employees.     

Family dysfunction, parental attachment, and career search self-efficacy among community college students.

The relationship between family dysfunction, parental attachment, and career search self-efficacy was examined using a sample of 220 community college students. For the total sample, attachment to mother and father, and degree of family dysfunction combined to account for 14% of the variance in career search self-efficacy. Data were analyzed separately for men and women, which yielded results consistent with the literature. For women, attachment to mother and degree of family dysfunction combined to account for 17% of the variance in career search self-efficacy. For men, attachment to mother was the only significant predictor and accounted for 9% of the variance in career search self-efficacy. Implications for research and practice are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of self-efficacy in rehabilitation outcome among chronic low back pain patients.

Examined the role of self-efficacy beliefs in the rehabilitation of 45 low back pain patients participating in a 3-wk rehabilitation program. Increments in self-efficacy beliefs during the rehabilitation program were not associated with improved patient functioning at discharge from the program. However, in support of the theorized role of self-efficacy in behavior change, these increments in self-efficacy significantly predicted better patient functioning and less reported pain at the 6-mo follow-up assessment. Implications of these findings for the rehabilitation of low back pain patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality counts for a lot: predictors of mental and physical health of spouse caregivers in two disease groups

The purpose of this study were to examine the influence of personality on mental and physical health of spouse caregivers and to determine whether there were differences in such influences depending on disease context. The disease contexts compared were Alzheimer's disease (AD) and Parkinson's disease (PD; with no coexisting dementia)--both chronic, degenerative diseases of later life. It was predicted that personality would be related to mental and physical health, directly and indirectly, and that AD caregivers would have higher levels of perceived stress and worse mental and physical health outcomes. Participants in the study were 175 caregivers (88 AD; 87 PD) living at home with their ill spouses. The data provided an excellent fit to the hypothesized model of the relationships between personality, disease group, social support, perceived stress, and mental and physical health. Seventy-eight percent of the variance in mental health was accounted for and 35% of the variance in physical health was explained. Personality had significant direct and indirect effects on mental health and significant indirect effects on physical health. As predicted, AD caregivers had significantly worse mental health than PD caregivers; however, AD caregivers had better physical health than PD caregivers, controlling for other variables in the model. These results are discussed in relation to the existing caregiving and behavioral medicine literature. Future research should include different domains of personality--states and longer term self-regulatory processes in addition to traits--to advance models of caregiving processes further.     

Validity of a stage algorithm for physical activity in participants recruited from orthopedic and cardiac rehabilitation clinics.

Objective: For stage-matched interventions, individuals must be classified with respect to their previous behaviors and in conjunction with their future intentions. A novel procedure for the assessment of stages in physical activity was developed. For this, individuals' activity and their regarding intentions were compared with recommended levels of activity. The aim was to examine the psychometric properties. Design: In a cross-sectional study, stages were assessed in 366 study participants (84 in cardiac and 282 in orthopedic rehabilitation) in terms of their previous physical activity and their intention to perform recommended activity levels in the future. Main Outcome Measures: Stages of change were compared to self-reported behavior, intention, planning, self-efficacy, risk perception, pros, cons, and social support. Misclassification, sensitivity, specificity, receiver operating characteristic (ROC) curves, non-linear trends, and planned contrasts were computed. Results: In comparison to previous studies, sensitivity (44%–99%) was high and specificity was similar or low (3%–88%), depending on the type of validation outcome selected. When using less demanding criteria (i.e., less intensive activity), measurement quality decreased, although not always significantly. Applying contrast analyses, more than half of the predicted stage differences were confirmed. No main differences between orthopedic and cardiac, ambulant and stationary rehabilitation appeared and no interactions were found. Conclusion: The stage algorithm proved to have acceptable measurement qualities in study participants recruited in both cardiac and orthopedic rehabilitation. Especially in detecting Intenders and Actors the stage algorithm performed well. Mechanisms of adopting and maintaining recommended activity levels seem to operate equally in both groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)