Winifred A. Gebhardt

Need for intimacy in relationships and motives for sex as determinants of adolescent condom use

PURPOSE To investigate the extent to which need for intimacy in relationships and motives for sex are capable of distinguishing between adolescents who always have protected sex and adolescents who do not, with reference to both steady and casual relationships. METHODS Seven-hundred-and-one adolescents (424 males and 277 females) aged 15 to 23 years filled out a questionnaire assessing determinants of sexual behavior and various outcome behaviors, such as having casual sex and condom use. RESULTS Two-thirds of the participants (470) were sexually experienced. Discriminant functions using constructs of the Theory of Planned Behavior (attitude, subjective norm, self-efficacy), as well as the need for intimacy in relationships and motives for sex, were found to distinguish significantly between adolescents who always had protected sexual intercourse and adolescents who did not. This was valid both for sex within steady and within casual relationships. Besides a positive attitude and high perceived subjective norms, protected sex with a steady partner was characterized by low scores on the scale for the motive for sex to express love, and on the scale for the need for intimacy in relationships. Consistent condom use with casual partners was related to high self-efficacy, attitude, and perceived subjective norms, as well as a greater need for intimacy in relationships. Gender differences emerged with respects to determinants of (un)safe sex with casual partner(s), in that for males the variables of the Theory of Planned Behavior were most important in distinguishing those who had unsafe casual sex from those who had safe casual sex. For females, on the other hand, the variables concerning the meaning attached to having sex or to the relationship within which sex occurs seemed to be of more significance in explaining (un)safe sex with casual partner(s). However, owing to small subsamples, caution is warranted when interpreting these differences. CONCLUSIONS In adolescence, the factors which influence the decision to have (un)protected sex depend on the kind of relationship that exists between the partners. In addition, the goals which adolescents pursue with regard to their relationships and with regard to having sex fulfill an important role in the decision-making process whether to use condoms.

When Worries Make you Sick: A Review of Perseverative Cognition, the Default Stress Response and Somatic Health:

Perseverative cognition, such as worry and rumination, is a common reaction to stressful events. In this review, we present a self-regulation perspective on perseverative cognition and propose that it forms part of the default response to threat, novelty and ambiguity. This default response is enhanced in chronic worriers who show difficulties in recognizing signals of safety, due to excessive goal commitment and the use of perseverative cognition as a strategy to cope with perceived threats to goal attainment. It is proposed that worrying about stressful events increases the total amount of time that stress has a ‘wear and tear’ effect on the human body. Studies supporting this perseverative cognition hypothesis are reviewed. Moreover, we provide preliminary evidence that unconscious forms of perseverative cognition have substantial somatic health effects as well. In conclusion, a focus on perseverative cognition is warranted when investigating links between stressful events and somatic health.

Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research

BackgroundTo improve the implementation of innovations in healthcare settings, it is important to understand factors influencing healthcare professionals’ behaviors. We aimed to develop a generic questionnaire in English and in Dutch assessing the 14 domains of behavioral determinants from the revised TDF (Cane et al., 2012) that can be tailored to suit different targets, actions, contexts, and times of interest, and to investigate questionnaire items’ discriminant content validity.MethodsWe identified existing questionnaires including items assessing constructs within TDF domains and developed new items where needed. Nineteen judges allocated 79 items to one or more TDF domains. One-sample t-tests were used to examine the discriminant content validity of each item, i.e., whether items measured intended domains or whether items measured a combination of domains.ResultsWe identified items judged to discriminately measure 11 out of 14 domains. Items measuring the domains Reinforcement, Goals, and Behavioral regulation were judged to measure a combination of domains.ConclusionsWe have developed a questionnaire in English and in Dutch able to discriminately assess the majority of TDF domains. The results partly support Cane et al.’s (2012) 14-domain validation of the TDF and suggest that Michie et al.’s (2005) 12-domain original version might be more applicable in developing a TDF-based questionnaire. The identified items provide a robust basis for developing a questionnaire to measure TDF-based determinants of healthcare professionals’ implementation behaviors to suit different targets, actions, contexts, and times. Future research should investigate the concurrent and predictive validity and reliability of such a questionnaire in practice.

Desirability of control: psychometric properties and relationships with locus of control, personality, coping, and mental and somatic complaints in three Dutch samples

Desire for control (DC) or need for control has frequently been proposed as an important personality characteristic and as a possible crucial moderator within the fields of achievement, psychological adaptation, stress, and health. However, unlike locus of control, hardly any effort has been undertaken to assess the construct. An exception is the work of Burger and Cooper on the Desirability of Control Scale (1979). In the present study, the psychometric properties of a Dutch version of the DC scale were tested in three different samples (total N = 1044). Furthermore, relationships between DC, its subscales, and various psychological personality and outcome measures were examined. The results show that the psychometric properties of the original DC scale could be successfully transposed to the Dutch version. Furthermore, factor analyses (PCA) led to the construction of three reliable subscales: ‘control others’ (desire to be in charge of and control others), ‘control self’ (desire to control ones own life), and ‘relinquish control’ (desire to leave others in control). The pattern of relationships with convergent and outcome variables supports the interpretation of these subscales. For ‘control others’, as for the total DC scale (i.e. a total of all 20 items), the emphasis of these relationships was on dominance, active coping, and psychological adjustment. ‘Control self’ was mainly related to self‐sufficiency and independence, while ‘relinquish control’ was clearly associated with passive coping and poor psychological adjustment. In summary, the DC scale appears to be a psychometrically sound instrument to assess desire for control and its subdimensions. Copyright

COMPETING PERSONAL GOALS AND EXERCISE BEHAVIOUR

Research on the determinants of exercise behaviour has not assessed the role of personal goals which may be in conflict with exercising. A cross-sectional study showed that 312 nonexercisers, 466 people who exercised once or twice a week, and 202 people who exercised at the norm of at least three times a week differed significantly with respect to the number of important personal goals expected to be hampered by exercising at the norm. To be specific, the number of competing activities in the home was higher for the sedentary group than for those who exercised. Further, those who exercised at the norm reported fewer competing social activities than all other subjects and fewer competing self-developmental activities than the nonexercisers. Scores on the scale for activities outside the home did not differ significantly among the three groups. It is argued that any theoretical model of exercise behaviour should take into account the influence of competing personal goals on the initiation and continuation of exercise during leisure time.

Integrating social-psychological frameworks for health behavior research.

OBJECTIVE To review the social-cognitive theories that have predominated in research on determinants of healthbehaviors. METHODS Based on a literaturesearch,the theorieswere compared and critically analyzed. RESULTS Although the theories are somewhat successful in predicting health behaviors, the social-cognitive perspective is restricted to a unidirectional, nondynamic view of behavioral change and neglects the fact that individuals may differ with respect to the life goals they pursue. CONCLUSION Health behavior research should adopt a more integrative approach, including insights from stage and goal theories. The health behavior goal model is described as an example of such an approach.

Self-Regulation and Health Behavior: The Health Behavior Goal Model

Publisher Summary Many of the existing health behavior models, including the health belief model, the theory of planned behavior, Banduras social learning theory, and the protection motivation theory, can be regarded as rudimentary self-regulation models. However, because self-regulation can be defined as a sequence of actions and/or steering processes intended to attain a personal goal, one can question whether essential principles of self-regulation are represented adequately in these models. The target health behavior is defined in these models in an external way; that is, it is set for the individual without relating it to existing personal goals. Most health behavior models focus on one specific goal or target at a time, without linking this goal to higher-order or other behavioral goals. That integration in the personal goal structure gives both meaning and direction to movement toward a specific health target.Publisher Summary Many of the existing health behavior models, including the health belief model, the theory of planned behavior, Banduras social learning theory, and the protection motivation theory, can be regarded as rudimentary self-regulation models. However, because self-regulation can be defined as a sequence of actions and/or steering processes intended to attain a personal goal, one can question whether essential principles of self-regulation are represented adequately in these models. The target health behavior is defined in these models in an external way; that is, it is set for the individual without relating it to existing personal goals. Most health behavior models focus on one specific goal or target at a time, without linking this goal to higher-order or other behavioral goals. That integration in the personal goal structure gives both meaning and direction to movement toward a specific health target.

Implementation intentions for buying, carrying, discussing and using condoms: the role of the quality of plans

Forming implementation intentions (i.e. action plans that specify when, where and how a person will act) could be effective in promoting condom use on a large scale. However, the technique implies that people are able to form high quality implementation plans that are likely to induce behaviour change. Young single females, aged 16-30 years old, were asked to form either an implementation intention for the target behaviour using condoms (n = 159) or preparatory implementation intentions for buying, carrying, discussing and using condoms (n = 146). Condom preparations were assessed at follow-up 2 months later. The implementation intentions that participants formed were rated on quality. In general, it appeared hard for young women to form high quality general implementation intentions for the target behaviour condom use. Implementation intentions for the preparatory behaviours were of better quality than general implementation intentions. Females who formed strong implementation intentions in the preparatory behaviours condition were more committed to these plans and perceived them as more useful. Plan commitment and perceived usefulness predicted condom preparations at follow-up. We conclude that it is important to ask individuals to form implementation intentions for the preparatory behaviours rather than for the target behaviour alone.

Goal frustration, coping and well-being in the context of adolescent headache : A self-regulation approach.

The aim of this study was to investigate the relationships between goal frustration, coping and well‐being in the context of adolescent headache. Firstly, we investigated whether adolescents with weekly, monthly or no headache complaints differed with regard to the importance assigned to their personal goals, experience of goal frustration, coping with goal frustration and well‐being. Secondly, the extent to which goal and coping factors contributed to well‐being and whether this relationship differed according to the frequency of headache complaints was examined. For this purpose, 1202 adolescents aged 12–18 completed self‐report questionnaires in schools. Adolescents were divided into three groups based on their experience of headache: no headache reported (38%); monthly headache (40%); weekly headache (18%). Results show that these groups did not differ with respect to the importance they attach to goals. They did, however, differ according to experience of goal frustration, use of strategies to cope with goal frustration and well‐being, although effect sizes were small. After controlling for individual and headache characteristics, frustration of self acceptance and health goals, and the use of self blame, rumination and other blame were consistently related to lower well‐being. Moreover, interactions with headache group indicated that for adolescents with weekly headache, greater frustration of school and self acceptance goals and a lower importance assigned to health goals was more detrimental to well‐being than for those with no headache complaints. We conclude that frustration to goal pursuit and strategies for coping with this frustration are important factors in adolescent well‐being and may offer important targets for intervention.

With a little help from my goals: Integrating intergoal facilitation with the theory of planned behaviour to predict physical activity

OBJECTIVE Integration of a multiple goal theory approach into the theory of planned behaviour (TPB) to investigate how the perceived facilitating and conflicting relationships in multiple goal pursuit predict performance of a health-related behaviour. DESIGN Prospective design with 8-week follow-up. METHODS At baseline, perceived intergoal facilitation and intergoal conflict were measured using personal projects analysis supplemented with standard TPB measures for physical activity (PA). Self-reported PA was measured at follow-up 8 weeks later. N=137 participants completed measures at both time points (55.4% response rate at follow-up). RESULTS Hierarchical regression showed that perceived intergoal facilitation, but not intergoal conflict, directly predicted PA beyond intention and perceived behavioural control (PBC), accounting for more than 4% of additional variance in PA. Intergoal facilitation had an indirect effect on intention through attitude and PBC, and intention partially mediated the effect of intergoal facilitation on behaviour. CONCLUSION The perceived facilitating effect of pursuing other personal goals predicts the performance of a health-related behaviour over and above single behaviour-focused social cognitions.