Bärbel Knäuper

Compensatory health beliefs: scale development and psychometric properties

Compensatory Health Beliefs (CHBs) are beliefs that the negative effects of an unhealthy behavior can be compensated for, or “neutralised,” by engaging in a healthy behavior. “I can eat this piece of cake now because I will exercise this evening” is an example of such beliefs. The present research describes a psychometric scale to measure CHBs (Study 1) and provides data on its reliability and validity (Studies 2 and 3). The results show that scores on the scale are uniquely associated with health-related risk behaviors and symptom reports and can be differentiated from a number of related constructs, including irrational health beliefs. Holding CHBs may hinder individuals from acquiring healthier lifestyles, for example lose weight or exercise.

A little uncertainty goes a long way: State and trait differences in uncertainty interact to increase information seeking but also increase worry

This study examines the effect of an interaction between intolerance of uncertainty (IU) and situational uncertainty (SU) on worry due to uncertainty and on information seeking. Health providers may benefit from knowing when communicating uncertain information is beneficial. The study was a 2 (IU condition: high vs. low) × 2 (SU condition: high vs. low) experimental design resulting in four conditions to which university students (N = 153) were randomly assigned. IU was manipulated through a linguistic manipulation of responses to an IU questionnaire coupled with written false feedback. SU was manipulated by modifying the information participants read about a fictitious infection. Individuals in the high IU and high SU condition sought the most information and worried most due to uncertainty compared to people in the low IU and low SU condition, who sought the least information and worried least. Findings suggest that high IU may increase positive health behaviors such as screening intentions when individuals are faced with an uncertain health threat, but that it also increases worries due to that uncertainty. Providing opportunities for discussing ones emotional response to uncertainty and providing instrumental support for managing uncertainty (e.g., booking the follow-up appointment) is essential when communicating uncertain information.

The Impact of Age and Education on Response Order Effects in Attitude Measurement

This article addresses the impact of age and education on the emergence of response order effects. Previous research has suggested that response order effects are stronger for respondents with less formal education. Education, however, is negatively correlated with age. Therefore, the apparent educational differences in response order effects might in fact reflect differences in age. A series of meta-analyses of experiments originally conducted by Howard Schuman and Stanley Presser and subsequent hierarchical logistic regression analyses demonstrate that there is a statistically reliable relationship between response order effects and age and that this relationship is not explained by education. Age-related differences in response order effects may undermine substantive conclusions about age or generational differences in attitudes

Measuring health: Improving the validity of health assessments

A large number of test batteries, instruments, indices and scales promise to provide reliable and valid information about an individuals health status. It is often neglected, however, that the data gathered using these measures are based entirely on self-reports and are susceptible to a variety of biasing factors. This is of particular concern for health research because many questions are inherently ambiguous and require considerable interpretive work on the part of the respondent. A single term may cover a wide range of health-related symptoms, experiences, or events, making health-related questions highly susceptible to contextual influences. This article discusses a number of possible influences on individual responses and suggests several determinants of self-report validity. The paper is organized into two major parts. The first part demonstrates that the validity of survey responses can be enhanced substantially when knowledge about conversational dynamics is taken into account during the design stage of the questionnaire. The second part argues that respondents are motivated and able to provide valid information about their overall health status. The validity of global single-item measures of health status is examined, and a cognitive model is introduced that outlines how subjective health evaluations are made.

Looking back at anger: reference periods change the interpretation of emotion frequency questions.

When asked to report on behaviors and experiences, participants draw on the specified reference period to infer the question meaning: Short reference periods suggest that the question pertains to frequent experiences; long reference periods suggest that it pertains to rare ones. Because frequent experiences are typically less intense than rare ones, this meaning shift results in reports of different experiences. Three experiments support this analysis in the domain of emotion reports. Participants asked how frequently they get angry (a) assumed that the question refers to less intense and more frequent episodes when presented with a short (1-week) rather than a long (1-year) reference period, (b) reported more extreme episodes in the latter case, and (c) provided differential frequency reports. These differences reflect conversational inference processes and cannot be fully accounted for by memory search biases.

Fruitful plans: Adding targeted mental imagery to implementation intentions increases fruit consumption

Forming implementation intentions (‘If I encounter situation X, then I will perform behaviour Y!’) increases the probability of carrying out goals. This study tested the hypothesis that mental imagery targeting key elements of implementation intentions further increases goal achievement. The residents of a student residence were assigned the goal of consuming extra portions of fruit every day for 7 days and randomly assigned to one of four conditions: control (active rehearsal), implementation intentions, goal intention mental imagery or mental imagery targeted to the implementation intentions. Among low fruit consumers, but not high fruit consumers, fruit consumption at follow-up was higher in the targeted mental imagery group than in the other group, with the lowest fruit consumption in the control group. The findings suggest that it may be beneficial to use targeted mental imagery when forming implementation intentions.

Human Papillomavirus Vaccination Intentions and Uptake in College Women

OBJECTIVE Using the health belief model (HBM) and theory of planned behavior (TPB) as theoretical frameworks, the objectives of this study were: (a) to identify correlates of human papillomavirus (HPV) vaccination intentions and (b) to explore differences between correlates of HPV vaccination intentions and uptake. METHODS Undergraduate women (N = 447) who did not intend to receive (n = 223), intended to receive (n = 102), or had received (n = 122) the HPV vaccine were surveyed. Logistic regressions were conducted to examine the correlates of vaccination intentions and uptake. RESULTS Negative health consequences of the vaccine, physicians recommendation, positive attitudes toward the vaccine, and subjective norms were significant correlates of vaccination intentions. When comparing correlates of vaccination intentions to correlates of vaccination uptake, physicians recommendation, subjective norms, and perceived susceptibility to HPV were unique correlates of uptake. CONCLUSION Differences between correlates of vaccination intentions and uptake suggest that social influences of liked and trusted individuals may make an important and unique contribution in motivating young women to receive the HPV vaccine beyond other variables from the HBM and TPB. Future utilization of longitudinal designs is needed to understand which factors may cause individuals to decide to receive the HPV vaccine.

Collective memories of Germans and Japanese about the past half-century

We investigate the collective memories of two samples drawn in 1991, one from the former West Germany and one from Yokohama, Japan. In the early 1990s such samples included many members of World War II cohorts and also cohorts born long after that war had ended. We consider the relation of age, conceptualised as birth cohort, to the salience of memories of national and world events that were mentioned as important in response to a quite general open-ended question about the past half-century. The relations are similar across the two countries in so far as external events like World War II might have had similar impacts on each population, while each country is distinctive with regard to events that especially impinged upon it. Hypotheses about the importance of adolescence and early adulthood to the imprinting of memories are generally confirmed, but several types of evidence suggest the need to extend the delimiting ages to earlier than the mid-teens and later than the mid-twenties. Other evidence indicates the desirability of distinguishing between recent events that are the focus of media attention and earlier events that depend more fully on autobiographical memory.

School-based sleep promotion programs: Effectiveness, feasibility and insights for future research

Adolescent sleep restriction is prevalent in todays society and is associated with major negative consequences for adolescent development and well-being. In the present review, we examine efforts to reduce adolescent sleep restriction via school-based sleep promotion programs. Such programs effectively enhance sleep knowledge but usually do not succeed in maintaining sleep behavioral changes. This may be because insufficient consideration is given to the importance of integrating motivational components into the programs. We suggest that future interventions should consider the use of individually tailored approaches to sleep promotion. We recommend the use of motivational interviewing, which can detect individual differences in the degree of willingness to change, thus allowing motivational barriers to be adequately addressed on an individual basis. Furthermore, we suggest that individually tailored sleep promotion strategies could be delivered to a significant proportion of adolescents via internet-based communication.

Temptations elicit compensatory intentions.

The compensatory beliefs model proposes that when faced with temptation, people form intentions to behaviourally compensate for indulgence. By creating a scenario in which female dieters were either faced with a tempting, high caloric food choice or not, this experiment tested the hypotheses that (1) dieters form compensatory intentions when experiencing the mental conflict of wanting to lose weight but also desiring to eat, and that (2) forming compensatory intentions results in the decision to indulge. Results supported the hypotheses, providing foundational validation for the compensatory beliefs model.