Joan K. Wigal

The hierarchical factor structure of the coping strategies inventory

The structure of coping was examined in three studies by means of Wherrys approach to hierarchical factor analysis. A hierarchical model with three levels was identified that included eight primary factors, four secondary factors, and two tertiary factors. The eight primary factors (problem solving, cognitive restructuring, emotional expression, social support, problem avoidance, wishful thinking, self-criticism, and social withdrawal) identified dimensions of coping found in previous empirical research and theoretical writing. The emergence of the four secondary and two tertiary factors provided empirical support for two theoretical hypotheses concerning the structure of coping. Support for the constructs of problem- and emotion-focused coping hypothesized by Lazarus was obtained at the secondary level, and support for the constructs of approach and avoidance coping hypothesized by many theorists was obtained at the tertiary level. These findings suggest that both formulations may describe the structure of coping, albeit at different levels of analysis.

A self-management program for adult asthma. Part I: Development and evaluation☆☆☆★★★

BACKGROUND We developed and evaluated a self-management program for adult asthma. In developing the program, we considered questions of format and behavior control. The format we selected included components known to be effective in educational settings. We regulated asthma management behavior through the introduction of environmental cues. METHODS Seventy-six subjects, whose asthma was generally under medical control, were assigned randomly to either a treatment group or a waiting-list control group. Those in the treatment group were exposed to a 7-week program that incorporated proven features of providing effective training and establishing behavioral control. Subsequently, subjects in the control group received the treatment. Short-term evaluation of the treatment was made after the subjects in the experimental group were trained but before the control subjects were trained. Long-term evaluation was conducted after both groups of subjects were trained. RESULTS Over the short term, self-management training led to fewer asthma symptoms and physician visits and improvement in asthma management skills and cognitive abilities. Over the long term, self-management training was related to lower asthma attack frequency, reduced medication use, improvement in cognitive measures, and increased use of self-management skills. CONCLUSIONS The program improved asthma management in patients whose conditions were already under good medical control. The effects of the program were apparent a year after the conclusion of self-management training.

A Life Activities Questionnaire for Childhood Asthma

The paper describes the development and testing of a paper-and-pencil instrument, the Life Activities Questionnaire for Childhood Asthma, that can be applied to assess activity restriction in children with asthma. It describes how items for the instrument were selected to ensure the validity of the developed instrument. The method by which the reliability of the questionnaire was established is also discussed. The result is a valid and reliable instrument that should have wide applicability in measuring activity restriction because of childhood asthma. The developed instrument has potential use in clinical settings, research, and policy making.

A Life Activities Questionnaire for Adult Asthma

The development, testing, and applicability of an instrument, the Life Activities Questionnaire for Adult Asthma is described that can be used to assess activity restriction in adults with asthma. It explains how items for the instrument were selected to insure the validity of the developed instrument. The reliability of the questionnaire is also discussed. The result is a valid and reliable paper-and-pencil instrument that should have wide applicability as a component of quality of life measurement. This instrument has potential for functional use in clinical settings, research environments, and policy-making procedures.

The Revised Asthma Problem Behavior Checklist

The Asthma Problem Behavior Checklist (APBC) has proved to be an accurate and invaluable instrument for pinpointing potential behavioral problems in children with the disorder. This article presents the Revised Asthma Problem Behavior Checklist (RAPBC). The value of the RAPBC is that: (a) it has proven reliability when tested with asthmatic adults; (b) the change from a dichotomous yes/no format, used in the APBC, to a 5-point Likert-type answer format adds greater sensitivity to the instrument; and (c) data gathered with the RAPBC compare favorably to information gathered in two previous studies with the APBC. Considering the reliability and validity of the RAPBC, it should prove useful in both clinical and research settings.

Respiratory airway changes in response to suggestion in normal individuals.

&NA; Thirty normal individuals were told they were inhaling a substance that would either cause breathing difficulty (N = 15) or not affect breathing (N = 15). Total respiratory resistance was measured prior to and during inhalation. In reality, the subjects inhaled no substance; inhalation consisted of breathing normally into a respiratory resistance recorder. Individuals who received the former suggestion exhibited increased total respiratory resistance during inhalation, whereas individuals who received the latter suggestion did not. These observations demonstrated that the ability of suggestion to affect the respiratory airway is not limited to asthmatic individuals.

The effects of suggestion on the total respiratory resistance of nonasthmatic female subjects.

Bronchodilation suggestion, bronchoconstriction suggestion, or neutral suggestion was given to thirty nonasthmatic female subjects; the effect of the suggestion on the total respiratory resistance (Rt) of the subjects was examined. Subjects were told either (a) that they would inhale a substance which would make their breathing better, (b) that they would inhale a substance which would make their breathing worse, or (c) that they would inhale a substance which would have no effect on their breathing. In actuality, no subject inhaled any substance. Those subjects who were told that their breathing would worsen exhibited a reliable increase in R1, whereas those subjects who were told that their breathing would become better or that their breathing would not be affected exhibited no reliable change in Rt. This study confirmed earlier work, showing that bronchoconstriction suggestion increases Rt in healthy individuals. Furthermore, this study showed that bronchodilation suggestion alone is not sufficient to produce a decrease in Rt.

A method for studying controlled substance use: a preliminary investigation.

This study examined relapse following treatment in a smoking reduction program. Twenty-two smokers with an average daily smoking rate of 25.7 cigarettes were provided a reduction-oriented smoking self-management program. Subjects were then classified on the basis of their reduction at posttreatment. A 50% or greater reduction from pretreatment qualified subjects as successful reducers. To provide further understanding of controlled smoking, subjects who successfully maintained at least a 50% reduction (at three month follow-up) were compared to those subjects who were unable to maintain that level of reduced smoking. A set of cognitive, smoking history, and reduction motivation variables were used to compare the two groups in a stepwise discriminant function analysis. Two variables, internal locus of control and self-label as a nonsmoker, produced an overall correct classification rate of 88.9%. Multiple regression analyses further demonstrated the importance of these two cognitive variables; self-label and internal locus of control accounted for 50.4% of the variance in smoking at three months follow-up. The implications of these findings for future study of controlled smoking are discussed.

EXPERIMENTER EXPECTANCY IN RESISTANCE TO RESPIRATORY AIR FLOW

Objective The effect of experimenter expectancy was investigated on the resistance to respiratory air flow, measured as total respiratory resistance (Rt) in healthy individuals. Method: Each of three naive experimental assistants collected air flow resistance responses from 30 subjects who they had been told were either likely or unlikely to respond to the suggestion of breathing difficulty. Results: The subjects were assigned to the two conditions at random. The subjects who were described to the experimenters as being likely to respond exhibited greater Rt increases to bronchoconstriction suggestion than did the subjects who were described as unlikely to respond. Conclusions: These findings confirmed the presence of a source of variance that has not been considered previously in suggestion studies.