Lucy E. Napper

Self-Affirmation and the Biased Processing of Threatening Health-Risk Information

Self-affirming before reading about the link between alcohol and breast cancer promoted increased message acceptance among young women at higher risk. Differences were maintained on variables measured up to 1 month later. Relative to their nonaffirmed counterparts, higher risk, self-affirmed participants had higher ratings of risk, imagination, intention to reduce alcohol consumption, and negative affect, such as fear, while reading the leaflet. In contrast, there were no differences between the groups on measures of broader message acceptance (belief in the link, evidence strength). Thus, self-affirmation promoted acceptance of the personal relevance of the message, a critical step in the precaution adoption process. Overall, the findings support the view that self-affirmation in an unrelated domain can offset defensive processing of a threatening health message, promoting central route persuasion and producing consequential and durable increases in message acceptance.

Self-affirmation reduces smokers' defensiveness to graphic on-pack cigarette warning labels

OBJECTIVE Little is known about how smokers respond to graphic images depicting the health consequences of smoking. The authors tested whether smokers respond defensively to such images and whether allowing them to self-affirm reduces their defensiveness. DESIGN Young smokers (N = 87) were randomly allocated to self-affirm or perform a control task prior to viewing 4 images intended for future use on cigarette packs in the European Union. Measures were taken immediately postexposure and after 1 week. MAIN OUTCOME MEASURES Participants rated each image for threat and personal relevance. Once all 4 images had been viewed, they completed measures of intentions, self-efficacy, and perceived behavioral control for reducing cigarette consumption, negative thoughts and feelings about smoking, personal vulnerability to 6 smoking-related diseases, desire to quit, and plans to quit. At the 1-week follow-up, measures of self-reported smoking and desire to reduce consumption were taken. RESULTS Relative to controls, self-affirmed participants rated the images as more threatening and personally relevant, and they reported more negative thoughts and feelings and higher levels of control, self-efficacy, and intentions. Risk level moderated the effect of self-affirmation on relevance and intentions: Self-affirmation increased ratings on both measures among those who smoked more. In addition, self-affirmation moderated the threat-intention relationship, which was weaker in the self-affirmed group. At follow-up, motivation to reduce consumption remained higher in self-affirmed participants, but there were no differences in reported consumption. CONCLUSION Self-affirmation can promote less defensive responding even to visual material about well-established health risks such as smoking.

The Reliability and Validity of Drug Users' Self Reports of Amphetamine Use Among Primarily Heroin and Cocaine Users

Relatively few studies have addressed the psychometric properties of self-report measures of amphetamine use. This study examines the reliability and validity of the Risk Behavior Assessments (RBA) lifetime and recent amphetamine-use questions. To evaluate validity, 4027 out-of-treatment primarily cocaine and heroin users provided urine samples that were compared to self-report data; to evaluate reliability, 218 completed the RBA at two time points, 48h apart. In the overall sample, self-reports demonstrated moderately high validity, with a 95% accuracy rate (kappa=.54). When analysis was restricted to recent amphetamine users validity was slightly lower (71.5% accuracy; kappa=.41). Test-retest data indicated good reliability for self-reports of ever having used amphetamine (kappa=.79), and amphetamine use in the past 30 days (.75<r<.91). Out-of-treatment drug users provided accurate self-reports of amphetamine use. Reliable and valid measures are essential for describing and predicting trends in amphetamine use, evaluating the effectiveness of interventions, and developing policies and programs.

Developing and testing a self-affirmation manipulation.

We developed a new manipulation of self-affirmation that is simple to use, can be employed when circumstances prevent pre-screening or using essay-based methods, and has a highly equivalent control task. In the process, we addressed theoretical and empirical questions highlighted in a recent review as requiring attention. In comparison to five controls, the manipulation promoted positive changes on measures designed to test whether people are self-affirmed. It produced a similar pattern on these measures to an existing self-affirmation manipulation. The matched control also performed well. There was no evidence of mediation by mood or state self-esteem or moderation by trait self-esteem. We discuss the potential of the method and associated dependent measures in future self-affirmation research.

Development of the Perceived Risk of HIV Scale

Past studies have used various methods to assess perceived risk of HIV infection; however, few have included multiple items covering different dimensions of risk perception or have examined the characteristics of individual items. This study describes the use of Item Response Theory (IRT) to develop a short measure of perceived risk of HIV infection scale (PRHS). An item pool was administered by trained interviewers to 771 participants. Participants also completed the risk behavior assessment (RBA) which includes items measuring risky sexual behaviors, and 652 participants completed HIV testing. The final measure consisted of 8 items, including items assessing likelihood estimates, intuitive judgments and salience of risk. Higher scores on the PRHS were positively associated with a greater number of sex partners, episodes of unprotected sex and having sex while high. Participants who tested positive for HIV reported higher perceived risk. The PRHS demonstrated good reliability and concurrent criterion-related validity. Compared to single item measures of risk perception, the PRHS is more robust by examining multiple dimensions of perceived risk. Possible uses of the measure and directions for future research are discussed.ResumenEstudios previos han utilizado varios métodos para evaluar los riesgos percibidos de la infección del VIH; sin embargo, pocos han incluido los varios elementos que cubren las diferentes dimensiones de la percepción del riesgo o han examinado las características de los elementos individuales. Este estudio describe el uso del “Item Response Theory” (IRT) para desarrollar una medida básica del riesgo percibido de la infección del VIH (PRHS). A 771 participantes se les administro un sorteo de elementos a mano de entrevistadores calificados. Los participantes también rellenaron evaluaciones de riesgo que incluyen elementos para evaluar comportamiento de riesgo sexual, y 652 de los participantes tomaron pruebas para el VIH. La medida definitiva constaba de 8 elementos, elementos que incluyeron la evaluación de la estimación de probabilidad, juicios intuitivos, prominencia de riesgo. Las puntaciones más altas fueron asociadas con un número más elevado de parejas sexuales, relaciones sexuales sin protección, y relaciones sexuales bajo el influjo. Los participantes que resultaron seropositivos para el VIH reportaron niveles altos de riesgo percibido. El PRHS demostró buena fiabilidad y validez de criterio relacionado concurrente. En comparación con los métodos de evaluación del riesgo percibido de un solo elemento, el PRHS es más robusto en examinar dimensiones múltiples de riesgo percibido. Usos posibles de la evaluación y direcciones para investigaciones en el futuro son discutidos.

Use of crystal methamphetamine, Viagra, and sexual behavior.

Purpose of review Methamphetamine (meth) use has been shown in the literature to be associated with high-risk sexual behavior for both homosexual (MSM) and heterosexual samples for over a decade. The use of Viagra has also been shown to be associated with high-risk sexual behavior. The purpose of this review is to update the record on Viagra and on the combination of Viagra and meth use. Recent findings There is now strong evidence that the use of Viagra is associated with HIV seroconversion in MSM. The combination of taking both meth and Viagra is strongly associated with much higher sexually transmitted disease and HIV rates. There is some evidence that Viagra is associated with insertive and meth is associated with receptive anal intercourse by men. Summary The evidence is strong to support the relationship between Viagra use and HIV seroconversion now that more sophisticated analyses have been done. The meth–Viagra recreational drug combination is of very high risk. More research is needed to generate longitudinal and event-level data that are necessary to answer fine-grained questions about drug combinations and the relationship with sexual behavior.

RCT of Web-based Personalized Normative Feedback for College Drinking Prevention: Are Typical Student Norms Good Enough?

OBJECTIVES Personalized normative feedback (PNF) interventions are generally effective at correcting normative misperceptions and reducing risky alcohol consumption among college students. However, research has yet to establish what level of reference group specificity is most efficacious in delivering PNF. This study compared the efficacy of a web-based PNF intervention using 8 increasingly specific reference groups against a Web-BASICS intervention and a repeated-assessment control in reducing risky drinking and associated consequences. METHOD Participants were 1,663 heavy-drinking Caucasian and Asian undergraduates at 2 universities. The referent for web-based PNF was either the typical same-campus student or a same-campus student at 1 (either gender, race, or Greek affiliation), or a combination of 2 (e.g., gender and race), or all 3 levels of specificity (i.e., gender, race, and Greek affiliation). Hypotheses were tested using quasi-Poisson generalized linear models fit by generalized estimating equations. RESULTS The PNF intervention participants showed modest reductions in all 4 outcomes (average total drinks, peak drinking, drinking days, and drinking consequences) compared with control participants. No significant differences in drinking outcomes were found between the PNF group as a whole and the Web-BASICS group. Among the 8 PNF conditions, participants receiving typical student PNF demonstrated greater reductions in all 4 outcomes compared with those receiving PNF for more specific reference groups. Perceived drinking norms and discrepancies between individual behavior and actual norms mediated the efficacy of the intervention. CONCLUSIONS Findings suggest a web-based PNF intervention using the typical student referent offers a parsimonious approach to reducing problematic alcohol use outcomes among college students.

Acculturation-Related Stress and Mental Health Outcomes Among Three Generations of Hispanic Adolescents

Stress associated with acculturation and minority status among Hispanic youth is understudied. Using survey data from the Hispanic Stress Inventory–Adolescent Version (HSI-A), we examined psychosocial stress across eight domains including family economic stress and acculturation-gap stress in a national sample of three generations (first, second, and third or higher) of Hispanic adolescents (N = 1,263). Research questions addressed generation differences in frequency of stressor events (i.e., discrimination), appraisal of these events, and mental health symptoms. Results indicated that experiences of different categories of stress were significantly related to generation status. The first generation reported more stressors and greater stress appraisal than the third-generation adolescents. Similar levels of discrimination stress were reported by participants regardless of generation. The second-generation participants reported a greater number of Acculturation Gap Stressors than the third generation, and more delinquent and aggressor behaviors than first-generation participants. An acculturation paradox was found with greater stress exposure and stress appraisals in the first-generation youth, but with lower mental health symptoms than later generations. Family integrity and more traditional family values may buffer the negative impact of greater stressor exposure among immigrants and second-generation youth when compared with third-generation adolescents.

Convergent and discriminant validity of three measures of stage of change.

The University of Rhode Island Change Assessment (E. A. McConnaughy, J. O. Prochaska, & W. F. Velicer, 1983), the Stages of Change Readiness and Treatment Eagerness Scale (W. R. Miller & J. S. Tonigan, 1996), and the Readiness to Change Questionnaire (S. Rollnick, N. Heather, R. Gold, & W. Hall, 1992) are commonly used multidimensional measures of stage of change. The authors examined the convergent and discriminant validity of drug-use versions of these 3 measures through multitrait-multimethod analysis in a population of indigent, out-of-treatment drug users (N = 377). Agreement in stage-of-change assignment and the relationship between stage of change and drug-use behaviors were also examined. Confirmatory factor analysis suggests that the Stages of Change Readiness and Treatment Eagerness Scale may have questionable convergent validity with the University of Rhode Island Change Assessment and Readiness to Change Questionnaire. There was moderate agreement in stage assignment. Analysis of behavior did provide some support for the construct validity of the measures. The results suggest that these drug-use stage-of-change measures may not be equivalent.

The Hispanic Stress Inventory--Adolescent Version: a culturally informed psychosocial assessment.

A 2-phase study was conducted to develop a culturally informed measure of psychosocial stress for adolescents: the Hispanic Stress Inventory--Adolescent Version (HSI-A). Phase 1 involved item development through the collection of open-ended focus group interview data (n = 170) from a heterogeneous sample of Hispanic youths residing in the southwest and northeast United States. In Phase 2, we examined the psychometric properties of the HSI-A (n = 1,651), which involved the use of factor analytic procedures to determine the underlying scale structure of the HSI-A for foreign-born and U.S.-born participants in an aggregated analytic approach. An 8-factor solution was established, with factors that include Family Economic Stress, Acculturation-Gap Stress, Culture and Educational Stress, Immigration-Related Stress, Discrimination Stress, Family Immigration Stress, Community and Gang-Related Stress, and Family and Drug-Related Stress. Concurrent, related validity estimates were calculated to determine relations between HSI-A and other measures of child psychopathology and behavioral and emotional disturbances. HSI-A total stress appraisal scores were significantly correlated with both the Childrens Depression Inventory and the Youth Self Report (p < .001). Reliability estimates for the HSI-A were conducted, and they yielded high reliability coefficients for most factor subscales, with the HSI-A total stress appraisal score reliability alpha at .92.