Michelle Morgan

A brief psycho-educational group intervention for postnatal depression.

OBJECTIVE To evaluate the efficacy of a controlled psycho-educational group (PEG) intervention for postnatal depression, compared with Routine Primary Care (RPC). DESIGN AND METHOD The participants were 45 women scoring above 12 on the Edinburgh Postnatal Depression Scale who were allocated to the study conditions using block randomization procedures. Short- and long-term changes in mood and psychosocial measures were assessed. RESULTS Compared with RPC, the PEG significantly reduced the level of depressive symptoms, but had no impact on psychosocial outcome. CONCLUSION A brief PEG is an effective form of treatment for women with low post-partum mood.

The need for wider dissemination of CPR skills: are schools the answer?

The value of instructing members of the public in CPR is now widely recognised, but community training schemes which rely largely on volunteers may fail to reach their targets. CPR training for lay people is often a once only activity and it has been shown that, without revision, skills deteriorate rapidly. By teaching CPR in secondary schools all social classes and ethnic groups could be reached, and retention of skills improved by regular revision. Health education has shown that it may be beneficial to use older pupils as instruction assistants.

TEACHING SCHOOLCHILDREN CARDIOPULMONARY RESUSCITATION

Forty-one children aged 11-12 years received tuition in cardiopulmonary resuscitation (CPR) and subsequently completed questionnaires to assess their theoretical knowledge and attitudes their likelihood of performing CPR. Although most children scored well on theoretical knowledge, this did not correlate with an assessment of practical ability using training manikins. In particular only one child correctly called for help after the casualty was found to be unresponsive, and none telephoned for an ambulance before starting resuscitation. These omissions have important implications for the teaching of CPR and the resulting effectiveness of community CPR programmes.

Developmental and individual differences in visual memory span

The effects of chronological age (5+, 7+, 10+, and adult), articulatory suppression and spatial ability were assessed on three measures (recognition memory, partial recall, and free recall) of visual memory span for patterns, using a procedure devised by Wilson, Scott & Power (1987). Although span increased into adulthood for all three tasks, concurrent articulatory suppression acted to reduce span for the 10-year-old and adult subjects. The ability to generate accurate visuo-spatial representations at retrieval is perfectly well developed by 7 years of age. Speed of response was lengthened for the youngest age group, but was immune to the effects of concurrent articulatory suppression. Good spatial ability was associated with higher span estimates on all tasks, regardless of age. Whilst the data support the existence of a system for representing visual patterns, which increases in capacity with increasing chronological age, the system (or processes accessing it at retrieval) is not immune to verbal recoding strategies. The independent association of spatial ability with span is taken to imply that nonverbal encoding and/or maintenance strategies can act to boost visual span from at least 5 years of age.

A stress-coping transactional model of low mood following childbirth

The present study was designed to assess whether or not a transactional model of stress could predict low mood following childbirth in a sample of primiparous women. The research used a two-wave longitudinal design--data were collected during the last trimester of pregnancy (n = 306) and at approximately 6 weeks postpartum (n = 223). Depression vulnerability, social support, appraisal and coping style were assessed at Time 1, and concurrent levels of social support, stress and appraisal were assessed at Time 2. The proposed model was generally upheld: High Edinburgh Postnatal Depression scores were predicted by womens predisposition to depression, negative appraisals of an anticipated childcare stressor, perceptions of low antenatal support and a high use of avoidance coping. In addition, a high number of daily hassles reported since the beginning of pregnancy, stressful childcare events, perceptions of low postnatal social support and negative postnatal appraisals contributed to the onset of low postnatal mood. This model extends the utility of the diathesis-stress account of Postnatal Depression (PND) and has important implications for how PND is treated.

Affective and social‐cognitive predictors of behavioural change following first myocardial infarction

Objectives. To assess the utility of measures of affect and social-cognitive variables in predicting risk behaviours for coronary heart disease in post-myocardial infarction (MI) patients. Design. A longitudinal design was adopted with predictor variables measured while participants were in hospital and dependent variables (exercise, alcohol consumption, diet and smoking) measured 3 months following discharge. Method. A random sample of 43 patients with a first MI were identified on the wards and given a questionnaire measuring anxiety and depression, and measures of outcome and self-efficacy expectancies and intentions relevant to each risk behaviour. Thirtyseven participants completed further behavioural measures at 3-month follow-up (excluding those who died in the follow-up period), a 90% completion rate. Results. Social cognition measures were predictive of later behaviour, and in particular light exercise. Here, intentions accounted for 51% of the variance in behaviour explained after partialling out pre-MI levels of exercise. Affect was less predictive, explaining only 7% of the variance in light exercise. Conclusions. Beliefs and intentions about future risk behaviour are formulated in the immediate post-infarction period. Future rehabilitation programmes would benefit from some intervention, probably educational, at this early stage.

The Sensitivity of Children and Adults as Tutors

Summary In view of conflicting claims about childrens sensitivity to the needs of other children in learning situations, the present study was designed to explore the sensitivity of child and adult tutors in one‐to‐one tutoring interactions. Sixteen adults and 31 11‐ and 9‐year‐olds tutored 47 9‐year‐old tutees on an animal classification task. Tutors were tested on their ability to apply the rules and knowledge they had obtained after training, and tutees were tested after being tutored. On all the verbal and nonverbal tutoring indices adult tutors showed greater sensitivity than child tutors: they were more likely to display behaviours which promoted efficient learning in their tutees. Results suggested that tutors operated on the basis of an implicit theory of teaching which involves three types of sensitivity: (1) sensitivity to the learners need to have sufficient information for understanding the task, coupled with adequate checks on the learners understanding; (2) sensitivity to the learners ne...

Social education is good for health1

Summary Results from a survey of smoking prevalence among 10,529 pupils from ten co‐educational comprehensive schools in the County of Avon suggest a clear relationship between smoking prevalence and the place of smoking education in the school curriculum. Based on pupils’ recall of lessons, the schools were split into those in which smoking was dealt with more predominantly within (broadly) biology/science lessons as distinct from the social education part of the curriculum. Within the six schools where this ‘science bias’ in smoking education was relatively high, the overall percentage of self‐reported daily smokers was 15.0 per cent compared with 10.1 per cent in the remaining schools with a lower science bias. This finding appears not to be influenced by the social class catchment of the schools, as judged from pupils’ reports of their fathers’ occupations, even though individual pupils’ smoking was related to their own fathers’ occupational status. 1. This study was supported by a grant from the Heal...

The development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers

This paper describes the development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers (low dependence drinkers consuming more than recommended levels). This work, which forms part of a larger matching study of brief intervention, is based on the general proposition that outcome expectations of reduced consumption might be more important than previously thought for understanding and predicting behavior change. Twelve outcomes, derived from interviews with excessive drinkers, formed the basis of a questionnaire, the Excessive Drinker Outcome Expectations Scale (EDOES), which examined not only the valence of each outcome, but a comparison between expectations of reduced consumption versus drinking usual amounts. The questionnaire was administered to 235 hospitalized excessive drinkers. Principal components analysis produced two scales, reflecting the costs and benefits of change. The questionnaire proved to have acceptable levels of test-retest reliability and predictive validity. Analyses of construct validity revealed that outcome expectations of reduced consumption were increasingly positive across stages of change.

Belief correlates of perceived addiction in young smokers

Results from a survey of smoking prevalence and smoking beliefs among 10,579 pupils from 10 co-educational comprehensive schools from the Bristol conurbation suggest that there is more to adolescent smoking than a vulnerability to peer group pressure. Those adolescents who saw themselves as more addicted, those who anticipate more difficulty in stopping and/or reported more craving for cigarettes had more «external control» beliefs about their health, emphasized to a greater extent intrinsic enjoyment and the calming effect of smoking and rejected ideas that smoking by young people is motivated by the desire to look grown up or feel important. Young smokers appear to attribute their behaviour to the intrinsic benefits of smoking itself rather than to external pressure or to the desire to conform to peer group norms. The implications of these findings for health education programmes are discussed.RésuméUne enquête par questionnaire a été effectuée auprès de 10 579 élèves de 10 «compréhensives schools» mixtes de la région urbaine de Bristol. Les questions concernaient la fréquence de l’usage du tabac et les opinions des sujets à propos de cet usage. Les résultats suggèrent que l’usage du tabac par les adolescents est plus, pour eux, que la conséquence de leur vulnérabilité aux pressions du groupe des pairs. Les adolescents qui se perçoivent eux-mêmes comme plus dépendants, ayant du mal à arrêter de fumer et/ou ayant un besoin maladif de cigarettes, affichent par ailleurs davantage d’opinions de type «contrôle externe» concernant leur santé; ils insistent également de façon plus importante sur le plaisir intrinsèque que donne le tabac, son effet calmant, et rejettent l’idée que l’usage du tabac par les jeunes soit motivé par le désir de paraître plus grand ou de se sentir important. Les jeunes fumeurs attribuent leur comportement aux bénéfices intrinsèques de l’usage du tabac plutôt qu’à des pressions externes et au désir de se conformer aux normes du groupe des pairs. Les implications de ces résultats concernant les programmes d’éducation de la santé font l’objet d’une discussion.