Gertraud Stadler

Intervention Effects of Information and Self-Regulation on Eating Fruits and Vegetables Over Two Years

OBJECTIVE This study tested whether an intervention that combined information with self-regulation strategies had a better effect on eating fruits and vegetables than an information-only intervention. DESIGN Women between age 30 and 50 (N = 255) participated in a 24-month randomized controlled trial comparing two brief interventions: All participants received the same information intervention; participants in the information plus self-regulation group additionally learned a self-regulation technique that integrates mental contrasting with implementation intentions. MAIN OUTCOME MEASURES Participants reported in daily diaries how many servings of fruits and vegetables they ate per day during 1 week at baseline, and in the first week, 1, 2, 4, and 24 months after intervention. RESULTS Participants in both groups ate more fruits and vegetables (0.47 to 1.00 daily servings) than at baseline during the first 4 months after intervention. Two years later, participants in the information plus self-regulation group maintained the higher intake, whereas participants in the information group returned to baseline levels. CONCLUSION Adding self-regulation training to an information intervention increased its effectiveness for long-term behavior change.

Physical activity in women: effects of a self-regulation intervention.

BACKGROUND A physically active lifestyle during midlife is critical to the maintenance of high physical functioning. This study tested whether an intervention that combined information with cognitive-behavioral strategies had a better effect on womens physical activity than an information-only intervention. DESIGN A 4-month longitudinal RCT comparing two brief interventions was conducted between July 2003 and September 2004. Analyses were completed in June 2008. SETTING AND PARTICIPANTS 256 women aged 30-50 years in a large metropolitan area in Germany. INTERVENTION The study compared a health information intervention with an information + self-regulation intervention. All participants received the same information intervention; participants in the information + self-regulation group additionally learned a technique that integrates mental contrasting with implementation intentions. MAIN OUTCOME MEASURES Self-reported minutes of moderate-to-vigorous physical activity per week. RESULTS Participants in the information + self-regulation group were twice as physically active (i.e., nearly 1 hour more per week) as participants in the information group. This difference appeared as early as the first week after intervention and was maintained over the course of the 4 months. Participants in the information group slightly increased their baseline physical activity after intervention. CONCLUSIONS Women who learned a self-regulation technique during an information session were substantially more active than women who participated in only the information session. The self-regulation technique should be tested further as a tool for increasing the impact of interventions on behavioral change.

Implementation intention and planning interventions in Health Psychology: Recommendations from the Synergy Expert Group for research and practice

The current article details a position statement and recommendations for future research and practice on planning and implementation intentions in health contexts endorsed by the Synergy Expert Group. The group comprised world-leading researchers in health and social psychology and behavioural medicine who convened to discuss priority issues in planning interventions in health contexts and develop a set of recommendations for future research and practice. The expert group adopted a nominal groups approach and voting system to elicit and structure priority issues in planning interventions and implementation intentions research. Forty-two priority issues identified in initial discussions were further condensed to 18 key issues, including definitions of planning and implementation intentions and 17 priority research areas. Each issue was subjected to voting for consensus among group members and formed the basis of the position statement and recommendations. Specifically, the expert group endorsed statements and recommendations in the following areas: generic definition of planning and specific definition of implementation intentions, recommendations for better testing of mechanisms, guidance on testing the effects of moderators of planning interventions, recommendations on the social aspects of planning interventions, identification of the preconditions that moderate effectiveness of planning interventions and recommendations for research on how people use plans.

The interplay of received social support and self-regulatory factors in smoking cessation

Objective: In smoking cessation, individual self-regulation and social support have both proven to be useful. However, the roles of self-regulatory processes and social support are mostly examined separately. The present study aims at examining the unique and joint interactive effects of self-regulation as specified in the health action process approach (HAPA) and social support on smoking cessation. The study tested whether social support can compensate for low levels of self-regulation or whether synergistic effects emerge. Design & Measures: Around a self-set quit date, 99 smokers completed baseline questionnaires on HAPA-variables, smoking-specific received social support and smoking cessation (continuous abstinence and point prevalence), with a follow-up Cpproximately 29 days after the quitdate. Results: Social support moderated the association between volitional self-efficacy and smoking, as well as coping planning and smoking but not between action planning and smoking. No compensatory effect of social support for lower levels of individual regulation emerged but the combination of high levels of the individual variables and social support was related to successful smoking cessation, indicating a synergistic effect. Conclusions: The results confirm the importance of examining both self-regulation and social factors in smoking cessation. This should be considered when developing future interventions for smoking cessation.

Physical Activity, Affect, and Cognition in Children With Symptoms of ADHD:

Objective: To examine the role of physical activity in determining the affect and executive functioning of children with symptoms of ADHD. Method: In Study 1, the association between physical activity and affect in the daily lives of children with varying degrees of hyperactivity was examined. In Study 2, children with ADHD were randomly assigned a physical activity or a sedentary task before working on a task requiring executive control. Results: Lack of physical activity was shown to relate to depressed affect, more strongly in participants with severe hyperactivity symptoms (Study 1). The physically active participants showed improved executive functioning after only 5 min of vigorous activity; the sedentary control participants showed no improvement (Study 2). Conclusion: These results indicate that interventions to increase the level of physical activity in children with and without ADHD might improve affect and executive functioning.

Daily negative affect and smoking after a self-set quit attempt: The role of dyadic invisible social support in a daily diary study.

OBJECTIVES Social support receipt from ones partner is assumed to be beneficial for successful smoking cessation. However, support receipt can have costs. Recent research suggests that the most effective support is unnoticed by the receiver (i.e., invisible). Therefore, this study examined the association between everyday levels of dyadic invisible emotional and instrumental support, daily negative affect, and daily smoking after a self-set quit attempt in smoker-non-smoker couples. METHODS Overall, 100 smokers (72.0% men, mean age M = 40.48, SD = 9.82) and their non-smoking partners completed electronic diaries from a self-set quit date on for 22 consecutive days, reporting daily invisible emotional and instrumental social support, daily negative affect, and daily smoking. RESULTS Same-day multilevel analyses showed that at the between-person level, higher individual mean levels of invisible emotional and instrumental support were associated with less daily negative affect. In contrast to our assumption, more receipt of invisible emotional and instrumental support was related to more daily cigarettes smoked. CONCLUSIONS The findings are in line with previous results, indicating invisible support to have beneficial relations with affect. However, results emphasize the need for further prospective daily diary approaches for understanding the dynamics of invisible support on smoking cessation. Statement of contribution What is already known on this subject? Social support receipt from a close other has proven to have emotional costs. According to current studies, the most effective social support is unnoticed by the receiver (i.e., invisible). There is empirical evidence for beneficial effects of invisible social support on affective well-being. What does this study add? Confirming benefits of invisible social support for negative affect in a health behaviour change setting Providing first evidence for detrimental effects of invisible social support on smoking.

Forty years on: Childhood intelligence predicts health in middle adulthood.

OBJECTIVE To investigate whether childhood general intelligence, fluid intelligence (Gf), and crystallized intelligence (Gc) predict various health outcomes in middle adulthood. METHOD This prospective longitudinal study followed a nationally representative sample of 717 Luxembourgers. Intelligence and socioeconomic status (SES) were measured at age 12; physical, functional, and subjective health were assessed at age 52. RESULTS Childhood general intelligence and fluid intelligence showed substantial positive effects on adult health outcomes, whereas the corresponding effects of crystallized intelligence were considerably smaller. CONCLUSION Childhood intelligence incrementally predicts various dimensions of adult health across 40 years-even in a country in which all citizens are guaranteed access to high-quality health care.

Within‐Person Link between Depressed Affect and Moderate‐to‐Vigorous Physical Activity in Adolescence: An Intensive Longitudinal Approach

BACKGROUND During adolescence, young women and men frequently show low physical activity and elevated depressed affect. This study aimed to examine the within-person link between moderate-to-vigorous physical activity (MVPA) and depressed affect in everyday life. METHODS Within an intensive longitudinal approach, adolescents (N = 72; 37% young women; M age = 17.36 years; age range: 12-26 years; mid-90% age range: 13-22 years) wore accelerometers to assess their daily MVPA and reported next-morning and same-evening depressed affect in diaries over eight consecutive days. The within-person link between MVPA and depressed affect on the next morning (time-lagged prediction) and the same evening (same-day link) was analyzed with mixed-effects models. RESULTS More-than-usual MVPA significantly predicted less next-morning depressed affect on weekdays in young women, to the extent that a 60-min increase in MVPA over the person mean significantly predicted 50 per cent lower next-morning depressed affect. CONCLUSIONS This study encourages the development of individually tailored physical activity interventions that could help adolescents enhance their daily amount of unstructured, self-initiated MVPA to reduce depressed affect. This approach may be particularly suitable for young women who have the highest risk for an inactive lifestyle and elevated depressed affect.

Hyperactivity and Motoric Activity in ADHD: Characterization, Assessment, and Intervention

The aim of the present literature review is threefold. (1) We will review theories, models, and studies on symptomatic hyperactivity and motoric activity in attention-deficit/hyperactivity disorder (ADHD). (2) Another focus will be on assessment methods that have been proven to be effective in the detection of hyperactivity and motoric activity in children, adolescents, and adults with and without ADHD and emerging areas of research in the field of ADHD. We will compare subjective methods (i.e., rating scales) and objective methods (i.e., accelerometers). (3) Finally, physical activity intervention studies aiming at a modification of activity and overactive behavior will be summarized that seem to be promising candidates for alleviating hyperactivity symptoms in children, adolescents, and adults with ADHD.

ADHD Symptoms in Adolescents' Everyday Life: Fluctuations and Symptom Structure Within and Between Individuals.

Objective: This study investigated whether self-reported ADHD symptoms fluctuate substantially within adolescents from day to day, and examined the underlying symptom factor structure on a within- and between-person level. Method: Adolescents (N = 166) rated their ADHD symptoms over the phone on eight consecutive evenings (total ratings: n = 1,264). Results: ADHD symptoms showed substantial fluctuations within adolescents from day to day, as indicated by within-person standard deviations and intraclass correlation coefficients. Both a two-level factor model with three correlated factors (inattention, hyperactivity, impulsivity) and a two-level bifactor model with a general ADHD symptom factor and a specific inattention factor provided acceptable to good accounts of the structure underlying daily ADHD symptom ratings on the between- and the within-person level. Conclusion: The study demonstrates that adolescents’ ADHD symptoms fluctuate from day to day and highlights the need for intensive diagnostic processes with repeated symptom assessments and interventions that address symptom fluctuations.