The impact of education and heart attack on smoking cessation among middle-aged adults

Considerable evidence supports the premise that higher levels of education lead to enhanced health, including protective health behaviors. This paper focuses on how education affects one health behavior known to lead to enhanced health: the cessation of smoking. In particular, the authors examine the extent to which education influences the decision by middle-aged adults to quit smoking following a heart attack, a potentially life-threatening health event. We first hypothesize that middle-aged adults with more formal education will stop smoking more readily than people with less formal education following the experience of a heart attack. Second, we ask what other factors might underlie and explain that hypothesized effect. Using longitudinal data, the authors track changes in individual smoking behaviors after a heart attack among preretirement-age Americans. We control for documented correlates of smoking and heart attack plus other factors associated with education, heart attack, and smoking that may also influence whether a person quits smoking. In addition to confirming evidence on the education-health association as well as the documented connection between heart attack and smoking cessation, this study provides a surprising twist on those links: Our results show that the move to quit smoking following the experience of a heart attack among middle-aged adults is significantly and dramatically moderated by their level of educational attainment.     

Public understanding of climate change in the United States.

This article considers scientific and public understandings of climate change and addresses the following question: Why is it that while scientific evidence has accumulated to document global climate change and scientific opinion has solidified about its existence and causes, U.S. public opinion has not and has instead become more polarized? Our review supports a constructivist account of human judgment. Public understanding is affected by the inherent difficulty of understanding climate change, the mismatch between people's usual modes of understanding and the task, and, particularly in the United States, a continuing societal struggle to shape the frames and mental models people use to understand the phenomena. We conclude by discussing ways in which psychology can help to improve public understanding of climate change and link a better understanding to action. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Influences on the felt need for collective bargaining by business and science professionals.

Examined the extent to which samples of professionals working in industry are interested in unionization and some of the factors that are associated with this interest. 26 "business" professionals and 38 "science" professionals indicated in a survey questionnaire how they felt about the necessity for collective bargaining. They also completed selective sections of the Management Styles Survey to report how they felt about their jobs, the fairness of people, their supervisors' style, and their organizations. Although the professionals as a whole were close to the midpoint in felt need for collective bargaining, science professionals felt much more need than did business professionals. Additional covariance was associated with disbelief in the fairness of people, an authoritarian rather than a consultative boss, job insecurity, and perceived lack of trust in the organization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social intelligence deficits in autistic children and adolescents--subjective theories of psychosocial health care professionals

The paper is concerned with personal theories of health care professionals about deficiencies in social intelligence of autistic persons. In the component-model of social intelligence means the ability of individuals or groups, to interact with each other in social situations. This contains social perception, social behavior as well as social conceptions and refers to emotional, cognitive and normative aspects. 33 interviewees, working as psychologists or teachers in kindergartens, schools or therapy institutions, are questioned by a half-standardized single interview concerning their beliefs about nonverbal social abilities, social perspective taking, and construction of a theory of mind in autistic persons. The major finding is: The impairments can be found in all aspects of social intelligence. Especially emotional handicaps, which are quoted by more than 80% of the interviewees, and low cognitive preconditions of mastering social stimuli, which are quoted by nearly all interviewees, are relevant. The subjective theories of the interviewees are in accordance to the models of parents as well as the models of the leading experts. The professional relationship to autistic persons and the practical experiences of the health care professionals lead to their specific personal theories of deficiencies in social intelligence of autistic people with wide consequences in respect to the professional contact with the autistic children and young adults.     

The relationship of ocular factors to the incidence and progression of age-related maculopathy

Modifying patients' sedentary lifestyle, a risk factor for many chronic diseases, is a challenge to health professionals. Although physicians can play a vital role in promoting physical activity among sedentary patients, the prevalence of physician-based exercise counseling is low. This paper presents a review of studies that have targeted physicians as agents of behavior change. Changing sedentary behavior is more likely to be effective when the intervention is grounded in theory. This paper outlines an integration of two theoretical models that have potential for enhancing behavior change, and it describes specific techniques for physicians interested in promoting a more active lifestyle among their patients.     

The experienced professional interviewer versus the complete novice.

Compared interviewer behavior and efficacy of complete novices and experienced professionals. In each of 2 studies interviewees were 16 female undergraduates. 16 interviewers were professionals, and 16 were novices. Interviewees rated the novices more benignly than the professionals but the professionals were rated as more skilled. There were no significant differences between the 2 groups on genuineness and warmth, with 1 questionable difference in favor of the professionals on empathy, as measured by the Truax and Carkhuff scales, Non-Possessive Warmth, Genuineness or Self-Congruence, and Accurate Empathy. Novice interviewers were more anxious (higher non-ah ratios). None of the payoff variables (e.g., productivity) in interviewee response distinguished between the professionals and novices. The "novice" but not the "professional" interviews conformed to a synchrony model on productivity. (42 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Special not different: general practitioners' accounts of their care of dying people

In modern Britain the majority of terminal care occurs in people's own homes and many dying people and their carers would prefer the death itself to occur in the home. The quality of terminal care in the home and the possibility of a home death depend to a great extent upon the care provided by GPs and community nurses. This paper reports on GPs' experiences of caring for dying people and their attitudes towards such work. It is based on unstructured interviews with 25 GPs who graduated from the 1979 entry cohort to the University of Leicester medical school. The respondents were recruited via a questionnaire following up previous research with this cohort on 'fear of death'. Although self-selecting, interviewees were not significantly different from those who did not volunteer for interview in any of the statistical analyses of the questionnaire data. There were a number of similarities in their accounts of their care of dying people. Common themes were that the care of dying people was important, rewarding and satisfying; that the GPs saw themselves as part of a team of carers, frequently as team co-ordinators; good working relationships with district nurses but less satisfactory relationships with hospitals and social workers; that patient and family were both recipients of care; and honesty in communication with dying people, albeit tempered. Three issues of contemporary relevance were: tensions over the role of hospice and specialist terminal care services; care of people with chronic terminal illnesses other than cancer; and the role of GPs in the social construction of bereavement.     

"Brain attack": the rationale for treating stroke as a medical emergency

Stroke is the third leading cause of death in the United States, behind only heart disease and cancer. With an estimated three million survivors of stroke in the United States, the cost to society, both directly in health care and indirectly in lost income, is staggering. Despite recent advances in basic and clinical neurosciences, which have the potential to improve the treatment of acute stroke, the general approach to the acute stroke patient remains one of therapeutic nihilism. Most basic science studies show that to be effective, acute intervention to reperfuse ischemic tissue must take place within the first several hours, as is the case with ischemic myocardium. In addition, most neuroprotective agents must also be administered within a short time frame to be effective at salvaging at-risk tissue. Recent studies have suggested that the outcome after intracerebral and subarachnoid hemorrhage is improved with early intervention. However, most stroke patients fail to present to medical attention within this short "window of opportunity." The public's knowledge about stroke is woefully inadequate. However, clinicians who deal with stroke can use the dramatic changes in the treatment of acute myocardial infarction over the last 2 decades as a guide for shaping changes in the management of acute stroke. Comprehensive educational efforts aimed at clinicians and the public at large have dramatically reduced the time from symptom onset to presentation and treatment for acute myocardial infarction, enabling treatment methods such as thrombolysis to be effective. The Decade of the Brain offers a unique opportunity to all concerned with the treatment of the patient with acute stroke to engage in a concerted effort to bring patients with a "brain attack" to specialized neurological attention within the same timeframe that the "heart attack" patient is handled. Such an effort is justified because, although at the present time there are few therapeutic interventions of "proven" value in the treatment of acute stroke, there is more than sufficient suggestive evidence that a number of approaches may be beneficial within the first few hours after the onset of the stroke.     

Differential construal and the false consensus effect.

People's own beliefs, values, and habits tend to bias their perceptions of how widely they are shared. The present research examined whether this "false consensus effect" is partly due to people's failure to recognize that their choices are not solely a function of the "objective" response alternatives, but of their subjective construal of those alternatives. Study 1 provided initial support for the importance of differential construal in people's consensus estimates by showing that larger false consensus effects tend to be obtained on items that permit the most latitude for subjective construal. Study 2 replicated this effect experimentally by asking Ss either a general or specific version of the same question. Larger false consensus effects were obtained on the general version that offered more latitude for construal. Studies 3 & 4 provided further support by showing that (a) Ss who made different choices tended to interpret the response alternatives in ways that reflected the choices they made and (b) subjects who were led to construe the alternatives in the same way tended to make the same choices. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about the helpfulness of interventions for mental disorders: a comparison of general practitioners, psychiatrists and clinical psychologists

OBJECTIVE: The aim of this study was to assess health professionals' beliefs about the helpfulness of a broad range of possible interventions for mental disorders. METHOD: The study involved a postal survey of 872 general practitioners (GPs), 1128 psychiatrists and 454 clinical psychologists. These health practitioners were presented with a vignette describing either a person with schizophrenia or one with depression. The vignettes were taken from an earlier survey of the general public. Respondents were asked to rate the likely helpfulness of various types of professional and non-professional help and of pharmacological and non-pharmacological interventions. RESULTS: Two-thirds or more of each profession agreed that the person with schizophrenia would be helped by GPs, psychiatrists, clinical psychologists, antipsychotic agents and admission to a psychiatric ward. Similarly, two-thirds agreed that the person with depression would be helped by GPs, psychiatrists, clinical psychologists, antidepressants, counselling and cognitive-behavioural therapy. However, there were also areas of disagreement. Psychiatrists were less likely than GPs and clinical psychologists to rate psychological and lifestyle interventions as helpful, while clinical psychologists were less likely to rate specifically medical interventions as helpful. Younger members of the professional groups and female members (who also tended to be younger) tended to rate a wider range of interventions for each disorder as likely to be helpful. CONCLUSIONS: Despite areas of broad agreement about treatment, health practitioners were more likely to endorse the interventions associated with their own profession. However, younger members of each profession tended take a broader view. If these age differences represent a cohort effect, health professionals may in the future show greater acceptance of the helpfulness of interventions offered outside their profession. These conclusions are limited by the methodology of the survey, which involved a questionnaire designed for the public rather than professionals.     

What's a good reason to change? Motivated reasoning and social accounts in promoting organizational change.

This study provides support for social accounts theory and motivated reasoning theory, both of which help explain how employees interpret the reasons that organizations undertake change. In a field study of a hospital implementing empowerment among nurses, staff nurses (n?=?501) cited 3 types of reasons as motivating the change: economic, quality improvement, and self-serving or political reasons. (The formal, managerially stated reason for the change was quality improvement.) Results generally supported social accounts theory regarding the managerial explanation. In this setting, however, many nurses did not believe the explanation management offered. Their alternative interpretations of the change were investigated from the perspective of motivated reasoning. Findings indicated that nurses' trust in management, their psychological contracts with the hospital, and the beliefs of their coworkers affected the reasons nurses cited for the change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factor reduction behaviours in coronary angioplasty and myocardial infarction patients

A recent study asked percutaneous transluminal coronary angioplasty (PTCA) patients in Saskatchewan (n = 210) to identify specific information surrounding their rehabilitation behaviours and motivation to change lifestyle. The scale used to elicit this information was developed and previously used to determine patient risk factor knowledge and lifestyle change behaviours among myocardial infarction (MI) patients during rehabilitation phases. The purpose of this article is to discuss the results of PTCA patients' responses and compare these findings to previously obtained data from MI patients. Risk factors most frequently reported by both PTCA and MI patients as causative factors of their heart problems included diet, job stress, low levels of exercise, and other patient-perceived factors. When asked about lifestyle restrictions post-hospitalization, PTCA patients reported more lifestyle restrictions in activities of daily living (recreation, job, social life, sexual activity and driving) following hospitalization than MI patients. Both groups of patients reported high levels of dietary changes made post-hospitalization but findings reflected that MI patients had initiated more modifiable risk factor changes overall than PTCA patients. Comparative results showed that MI patients were more likely to initiate risk factor reduction behaviours for modifiable factors such as smoking, weight reduction, job/family stress, and exercise than PTCA patients. These findings offer insight into differences between PTCA and MI patients with respect to cardiac rehabilitation behaviours and may suggest the need for different teaching-learning approaches and/or more focused patient education for PTCA patients. A goal of cardiac rehabilitation is to encourage patient initiation and maintenance of lifestyle modification behaviours based on identified risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)     

Lifestyle and mental health.

Mental health professionals have significantly underestimated the importance of lifestyle factors (a) as contributors to and treatments for multiple psychopathologies, (b) for fostering individual and social well-being, and (c) for preserving and optimizing cognitive function. Consequently, therapeutic lifestyle changes (TLCs) are underutilized despite considerable evidence of their effectiveness in both clinical and normal populations. TLCs are sometimes as effective as either psychotherapy or pharmacotherapy and can offer significant therapeutic advantages. Important TLCs include exercise, nutrition and diet, time in nature, relationships, recreation, relaxation and stress management, religious or spiritual involvement, and service to others. This article reviews research on their effects and effectiveness; the principles, advantages, and challenges involved in implementing them; and the forces (economic, institutional, and professional) hindering their use. Where possible, therapeutic recommendations are distilled into easily communicable principles, because such ease of communication strongly influences whether therapists recommend and patients adopt interventions. Finally, the article explores the many implications of contemporary lifestyles and TLCs for individuals, society, and health professionals. In the 21st century, therapeutic lifestyles may need to be a central focus of mental, medical, and public health. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Uncertainty orientation and trust in close relationships: Individual differences in cognitive styles.

Because coping with uncertainty is an important aspect of close relationships and is critical to issues of trust, the authors expected individual differences in uncertainty orientation to play a central role in shaping people's representations of their relationships. For a 3-week period, 77 couples completed a series of questionnaires and kept diaries on their interactions. As expected, certainty-oriented persons' need for cognitive closure resulted in either high or low trust for their partners, whereas uncertainty-oriented persons typically attained only a moderate level of trust. Several other measures indicated that certainty-oriented partners found their relationships most aversive under moderate trust. Memory data indicated that certainty-oriented individuals, but not uncertainty-oriented individuals, used conclusions about trust as a heuristic for reconstructing the past in ways that maintained cognitive clarity. Uncertainty orientation also combined with gender in many interesting ways. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical and nonclinical aspects of program development consultation.

Although program development can have therapeutic benefits for an organization and for its members, it is inappropriate to assume that consultation is simply therapy for groups; there are differences in goals and in methods. Organizational consultants can make errors if they work with organizations as therapists do with groups or treat organization members as if they were patients. On the other hand, both organizational consultants and psychotherapists need clinical sensitivity and skills at developing a setting of trust and openness. Both professionals encourage specificity and checking of assumptions and try to make explicit that which had been covert. Both groups find it effective to work with the "client system" rather than a specific "identical patient." Consultants working with groups can profit from clinical insight about the resistance of individuals and groups to change. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of trust in authority and procedural fairness on cooperation.

The present research examined the effect of procedural fairness and trust in an authority on people's willingness to cooperate with the authority across a wide range of social situations. Prior research has shown that the presence of information about whether an authority can be trusted moderates the effect of procedural fairness. If no trust information is available, procedural fairness influences people's reactions. This is not the case when information about the trustworthiness of the authority is present. In the present article, it is argued that information about whether the authority can or cannot be trusted may also moderate the effect of procedural fairness in predicting levels of cooperation. Assuming that the use of fair procedures by authorities that cannot be trusted is less influential than is the enactment of procedures by trustworthy authorities, it is predicted that trust in authority moderates the influence of procedural fairness on cooperation in such a way that procedural fairness has a positive effect on cooperation primarily when trust in authority is high. Results from 4 studies (2 experimental studies and 2 field studies) provide supportive evidence for this interaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal styles of chronically depressed outpatients: Profiles and therapeutic change.

Theoretical accounts posit that chronically depressed individuals are perceived as hostile and/or submissive, which compromises their ability to satisfy their interpersonal needs. The current study assessed the interpersonal tenets of McCullough's (2000) chronic depression theory and examined change in interpersonal functioning following McCullough's treatment for chronic depression (viz., Cognitive-Behavioral Analysis System of Psychotherapy; CBASP). Data derive from a randomized 12-week clinical trial that compared the efficacy of CBASP, nefazodone, and their combination for chronic depression. To assess patients' interpersonal impacts, CBASP therapists completed the Impact Message Inventory (IMI) following an early and a late session. IMI data were compared to normative and clinical comparison samples to assess depression-related interpersonal profiles and clinically significant change in interpersonal functioning. As predicted, chronically depressed patients were initially perceived as more submissive and hostile than the comparison groups. Patients' interpersonal impacts on their therapists changed in adaptive, theoretically predicted ways by the end of CBASP treatment, either with or without medication. Individual-level clinical significance data were less robust. The findings generally substantiate McCullough's interpersonal theory and provide preliminary evidence of change in interpersonal impacts following treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular reactivity to and recovery from psychological challenge as predictors of 3-year change in blood pressure.

The authors examined whether cardiovascular reactivity to and recovery from psychological challenge predict 3-year change in blood pressure (BP) among 216 initially normotensive, community-dwelling adults. Clinic BP assessments were conducted at baseline and follow-up. BP and heart rate (HR) readings were obtained before, during, and after 5 psychological tasks at baseline. Following adjustment for traditional predictors of BP and lifestyle factors, poorer systolic BP recovery across the tasks was associated with greater 3-year increases in clinic systolic and diastolic BP. Both diastolic BP recovery and HR recovery were also related to 3-year change in clinic BP, though cardiovascular reactivity measures were not. These findings suggest that the duration of stress-related cardiovascular responses may be important for predicting longitudinal changes in BP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"The perpetuation and evolution of biological science": Erratum.

Reports an error in the original article by Beach (American Psychologist, 1966[Oct], Vol 21[10], 943-949). On page 943, Footnote 1 should have read "the official opening of three new science buildings at McGill University." (The following abstract of this article originally appeared in record 1967-03566-001.) Students should be trained for the future rather than the present and increasing emphasis should be placed on increasing the understanding of human behavior. "The social environment in which biological science exists and to which it must adapt is currently in a state of rapid and complex change." The environment is ripe for the rapid diversification and expansion of behavioral studies. "All of the conditions are propitious for prompt evolutionary radiation of the parent species biological science.... Various combinations of neurology, endocrinology, microbiology, and psychology have been tried, and some of them have yielded promising results. New permutations must be devised and the resulting strains of biology must be given a chance to survive, to reproduce, and to evolve still further.... Man's greatest problem... is not to understand and exploit his physical environment, but to understand and govern his own conduct.... If he is to survive he must proceed to explore himself and to control his own activities." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-validational studies of the personality correlates of the A-B therapist "type" distinction among professionals and nonprofessionals.

Notes that research with the A-B therapist "type" variable has included many analog studies in which A and B undergraduates have been assumed to be personologically similar to A and B professionals. To assess whether this "invariance assumption" is tenable across samples varying in vocational commitment/training, sex, education, and adjustment, the personality correlates of A-B status (identified in a prior study with the Personality Research Form) was cross-validated across 5 new samples. A and B Ss among 94 male professionals, 661 male undergraduates, 114 male college clinic patients, and 720 female undergraduates were compared. Univariate and multivariate analyses lent strong support to the invariance assumption: in every sample, B-type Ss exceeded A-type Ss on scales measuring risk taking, dominance, change, sentience, and "counterdependence." (32 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)