An Exploratory Investigation of the Relationship between Proxy Efficacy, Self-efficacy and Exercise Attendance

The purpose of the study was to examine the relationship between perceptions of self-efficacy, proxy efficacy, and exercise class attendance of participants involved in a 10-week structured group fitness program. At week 3, 127 females completed measures of self-efficacy and proxy efficacy and their class attendance was monitored for the subsequent four weeks. Self-efficacy was assessed through measures of exercise, scheduling, and barrier self-efficacy. Proxy efficacy was assessed through a measure of fitness instructor efficacy defined as participants' confidence in their fitness instructors' communication, teaching, and motivating capabilities. Results revealed positive correlations between self-efficacy variables and proxy efficacy. Hierarchical multiple regression analyses indicated that among those who were classified as exercise initiates (n = 33), self-efficacy and proxy efficacy accounted for 34 percent of the variance in exercise class attendance with the latter variable explaining a unique 12 percent. Consistent with theorizing, these preliminary findings indicate that for instructor-led, group physical activities such as aerobics classes, proxy efficacy perceptions are related to self-efficacy and may also be an important predictor of exercise behavior.     

Cognitive Characteristics as Predictors of Children's Understanding of Safety and Prevention

Children's level of causal reasoning and cognitive style wereconsidered as possible predictors of their understanding ofsafety and prevention. Individual interviews conducted with112 children, aged 3 through 8 years, indicated that the abilityto differentiate between safe and unsafe situations occurredprior to the ability to specify preventive measures. An accurateunderstanding of safety and prevention was related to higherlevels of causal reasoning and to a reflective cognitive style.However, multiple regression analyses revealed that causal reasoningeliminated cognitive style as a significant predictor. In comparisonto 6- to 8-year-olds, the variability in 3- to 5-year-olds'performance on the predictor measures explained more of thevariance in their safety and prevention scores. These differencesare discussed in terms of children's stage of development andthe higher national rate of accidents among preschoolers comparedto school-age children. Implications of the results for safetyeducation programs and directions for future research are discussed.     

Chronic Health Illnesses as Predictors of Mild Cognitive Impairment Among African American Older Adults

Approximately 5.5 million individuals are diagnosed with Alzheimer's disease (AD) dementia, a number which includes those with mild cognitive impairment and asymptomatic individuals with biomarkers of AD. There is a higher incidence of mild cognitive impairment (MCI) in African American populations as compared to White populations, even when controlling for sociodemographic factors. The existing body of ethnically/racially targeted research on MCI has been limited by few studies with the ability to generalize to African American communities. This study sought to examine whether medical conditions which occur at a higher rate in African American individuals increase the hazard of subsequent MCI development.A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was employed to examine the associations between health conditions (congestive heart failure, traumatic brain injury, diabetes, hypertension, hypercholesterolemia, B12 deficiency, thyroid disease) and their relationship to MCI. The analytic sample included 2847 participants with 9872 observations. Binary logistic generalized estimating equation modeling was used to examine repeated measures over the course of 1–11 observations. Education was associated with MCI development, specifically those with some college or college graduates (p < 0.001) and more than college (p = 0.002). Female sex was associated with development of MCI (p < 0.001). African Americans with traumatic brain injury (TBI) were more likely to develop MCI (p < 0.001) compared to those with no reports of a TBI. Inactive thyroid conditions decreased the risk of MCI development (p = 0.005) compared to those without thyroid disease.Though vascular factors are often attributed to higher mortality and neurodegeneration in African Americans, congestive heart failure, diabetes, high cholesterol, hypertension, diabetes, nor seizures were associated with an increased risk of MCI development. Findings from this study provide formative data to develop targeted interventions for subsets of the African American community, including those with higher educational levels, those with TBI, and those with a history of thyroid disease. While it may not be possible to prevent MCI development, it is possible to modify lifestyle behaviors contributing to these health conditions, such as falls that are often experienced by older adults. Practitioners can increase awareness, knowledge, and resources relevant to clients.     

Social Cognitive Predictors of Sun Protection Intention and Behavior

The authors investigated sunbathing behavior and intention prospectively using the Theory of Planned Behavior (TPB). Before summer, 85 young adults who intended to sunbathe completed a TPB questionnaire. After summer, 46 of them completed a second questionnaire about their summertime sunbathing behavior. The proposed model was successful in predicting both behavior and intention to use sun protection, with 45% of the variance of self-reported sunscreen use and 32% of the variance in intention explained by the TPB. Items designed to measure self-efficacy and perceived control loaded onto different factors and demonstrated discriminant validity. Self-efficacy predicted both intention and behavior (after controlling for all other TPB variables), but perceived behavioral control did not. The authors discuss the implications of the findings for potential interventions to improve sun protection behavior.     

Predictors of Cognitive and Academic Outcome following Childhood Subcortical Stroke

ABSTRACT

Childhood arterial ischemic stroke often involves basal ganglia and thalamus but little is known about neuropsychological outcomes in this group. We examined intellectual ability, academics, attention, executive function, and psychological diagnoses in children and adolescents (6–20 years of age) with childhood stroke involving the basal ganglia (n = 32) or thalamus (n = 12). Intellectual ability was age-appropriate but working memory was significantly lower than expected. Compared to the normative mean, the stroke group exhibited significantly weaker performance in reading comprehension, math fluency, attention, and greater challenges with executive function. Children with basal ganglia stroke had weaker working memory and were more likely to receive diagnoses of Attention Deficit Hyperactivity Disorder and Anxiety Disorder than those with thalamic stroke. Lesion size was most important in predicting working memory ability, whereas age at stroke and age at test were important in predicting academic ability.     

Exercise as a treatment for depression: An update

The traditional treatments for nonbipolar affective disorders have been pharmacological. Recently, a number of well-designed studies have demonstrated the efficacy of different nonpharmacological treatments for depression. Exercise has been among the more novel approaches to the treatment of depression, and the antidepressant effects of exercise have received considerable popular attention. The early research reports on the effects of exercise on depression suffer from conceptual confusion and methodological problems. An appraisal of recent research, however, provides grounds for cautious optimism regarding the potential therapeutic effects of exercise.     

Heart Rate Reactivity, Behavior Pattern, and Parental Hypertension as Predictors of Cardiovascular Activity During Cognitive Challenge

Hemodynamic responses were studied during work on serial subtraction and digits backwards tasks in 99 healthy male undergraduates jointly classified as high or low heart rate reactors, Type A or Type B behavior pattern, and as having positive or negative parental history of hypertension. Heart rate, systolic blood pressure, and diastolic blood pressure were recorded, and rate pressure product was calculated at rest and during the tasks. High heart rate reactors to a cold pressor task responded with relatively higher heart rate and rate pressure product during both cognitive tasks than low heart rate reactors. Type A subjects defined by Jenkins Activity Survey did not differ from Type Bs on any of these physiological variables, although behavioral evidence demonstrated greater effort and superior performance by the Type As. Subjects with a positive parental history of hypertension manifested greater systolic and diastolic pressures and rate pressure product responses to the cognitive challenge than those lacking such parental history. These results indicate that the individual difference variables of heart rate reactivity and parental history of hypertension predicted different hemodynamic response patterns to behavioral challenge.     

Exercise and Diet Beliefs of Overweight Women Participating in an Exercise and Diet Program: An Elicitation Study Using the Theory of Planned Behavior1

The purpose of this study was to examine the exercise and diet beliefs of overweight women using the theory of planned behavior. Participants were 104 overweight community women and university students who completed a 4‐week exercise and diet program. The most salient exercise beliefs for the participants were (a) increased motivation, structure and accountability, and social support (behavioral beliefs); (b) job or school responsibilities and traveling (control beliefs); and (c) group members and the program trainer (normative beliefs). The most salient diet beliefs were (a) improved eating habits and convenience (behavioral beliefs), (b) lack of control over food preparation and inconvenience (control beliefs), and (c) family and spouse or significant other (normative beliefs). These results are discussed in comparison to beliefs held by different populations and in regard to implications for intervention design.     

强迫症的认知理论

强迫症的主要特征是强迫观念和强迫行为,患者有意识的自我强迫和自我反强迫共存。认知理论对强迫症的解释和治疗得到了大量的实证研究的支持。强迫信念对闯入性思想的评价是强迫症状得以发展和恶化的重要因素。几个有影响力的强迫症的认知模型分别介绍了不同的强迫信念是如何导致强迫症状的。可以采用认知治疗技术克服强迫思维。     

Efficacy of Akatinol Memantine in Moderate Cognitive Impairments

A six-month open clinical trial of the efficacy of Akatinol was conducted in 40 patients with moderate cognitive impairments (MCI) using piracetam (20 patients) as reference agent; mean age was 67.7 ± 7.2 years. Patient status was evaluated using a number of scales, questionnaires, and neuropsychological tests prior to treatment and at three and six months of treatment. Akatinol was given at a dose of 10 mg/day, and 20 patients received piracetam at a dose of 1200 mg/day. Studies were completed by 38 patients (95%) in the Akatinol arm and 18 (90%) in the piracetam arm. In the group treated with Akatinol, 5% reported deterioration, 20% no change, 35% moderate improvement, 25% marked improvement, and 15% great improvement. In the Akatinol arm, the proportion of patients without effects was significantly lower, while the proportions of patients with marked and great improvements were significantly higher than in the piracetam arm. Overall evaluation of cognitive functions on the MMSE scale showed significant increases in both groups by the end of the third month, though only patients receiving Akatinol maintained the improvements to the end of the sixth month. Akatinol treatment also produced positive changes in the symptoms of depression, subjective symptoms, and quality of life. More marked positive changes were seen in the dysregulatory type of MCI than in the amnestic type of MCI. The concept of MCI with a high risk of transformation to dementia is introduced; in this situation, treatment with Akatinol may be particularly relevant.     

Pretransplantation Cognitive Dysfunction in Advanced-Age Hematologic Cancers: Predictors and Associated Outcomes

Patients presenting for treatment of hematologic cancers may be at increased risk for cognitive dysfunction before allogeneic hematopoietic stem cell transplantation (HSCT) due to advanced age, previous chemotherapy treatment, deconditioning, and fatigue. Cognitive dysfunction may affect treatment decision making, ability to recall or follow post-HSCT treatment recommendations and overall survival (OS). A total of 448 patients admitted for HSCT between 2011 and 2014 were administered the Montreal Cognitive Assessment (MoCA) by occupational therapists during admission before transplantation, and 260 were reassessed following transplantation and before discharge. We examined select predictor variables, including age, Karnofsky Performance Status, sex, disease type, psychotropic medications, and select outcome variables, including OS, and nonrelapse mortality (NRM). Before transplantation, 36.4% of patients met criteria for cognitive dysfunction. Age was found to be a significant predictor, along with disease type (myelodysplastic syndrome [MDS], myeloproliferative disorder [MPD]). No significant association was found between cognitive dysfunction and OS or NRM. Longitudinal analysis from pretransplantation to post-transplantation indicated significant decline following HSCT. Notably, one-third of the study cohort showed cognitive dysfunction at hospital discharge. A significant proportion of HSCT candidates present with cognitive dysfunction, with older patients and those diagnosed with MDS and MPD at greatest risk in this cohort. Attention to cognitive dysfunction before transplantation may alert the treatment team to high-risk cases that require increased oversight, inclusion by caregivers, and referral to occupational therapy at discharge. Longitudinal follow-up studies are needed to clarify the specific effect of HSCT on cognitive dysfunction and the impact of cognitive dysfunction on transplantation outcomes.     

The Relationship Between Exercise Motives and Physical Self‐Esteem in Female Exercise Participants: An Application of Self‐Determination Theory1

This study examined the relationship between exercise motives and physical self‐esteem (PSE) in physically active females using Self‐Determination Theory (SDT; Deci & Ryan, 1985, 1995; Ryan & Deci, 2000). Female exercise participants recruited from university‐based exercise classes reported their motives for exercise during Week 2, and their levels of PSE during Week 12, of a 15‐week exercise class. Bivariate correlations indicated that exercise motives displayed a graded pattern of relationships. They also suggested that only autonomous exercise motives were associated with higher PSE. Discriminant function analysis revealed that more autonomous exercise motives correctly classified 83.3% of the high PSE group and 88.9% of the low PSE group. These findings support Ryan and Deci's assertions and suggest that autonomous exercise motives may play an important role in positive PSE in the exercise domain. These findings advance the application of SDT in the exercise domain and further our understanding of PSE development.     

Respiratory Patterns as Predictors of Laughter

Earlier research on respiratory patterns indicates that they are sensitive to emotional processes. Abdominal and thoracic patterns were therefore used as predictors of laughter responses in 25 subjects participating in an entertainment situation. The abdominal respiratory body circumference changes (the abdominal amplitude) of the women predicted their laughter responses; the greater the abdominal amplitudes during the entertainment period, the more frequent and enduring were their laughter responses. No prediction was obtained by the respiratory patterns of men. The results suggest that respiratory patterns are sensitive indicators of laughter response habits in women only. The variability of tonus in the abdominal muscles was suggested to be of particular importance to the results, i. e. great variability yields frequent and enduring laughter responses in women.     

The Importance of the Cognitive Theory of Change in Cognitive Therapy of Depression

This commentary addresses the article by Tang and De-Rubeis (in press), in which they propose that symptom change over the early course of cognitive therapy (CT) for depression is not due to nonspecific factors, as proposed by Ilardi and Craighead (1994) , because cognitive interventions are implemented during this stage. Although both articles raise important considerations regarding the necessary and sufficient treatment components of CT and the temporal course of change in CT, I argue here that neither article adequately addresses that which is specific to CT, namely, the cognitive theory of change. Empirical findings are reviewed regarding change In cognition during CT, and suggestions for future research are proposed that evaluate the specificity of CT in terms of the cognitive theory of change.     

Cognitive Predictors of Adaptive Functioning Vary According to Pediatric Brain Tumor Location

This archival study sought to determine if the relationship between cognitive and adaptive abilities varied according to brain tumor location. Participants were 36 children treated for brain tumors. The best cognitive predictors of adaptive functioning were hypothesized to be attention span within the cerebellar group and verbal memory within the third ventricle group. Auditory attention span significantly predicted communication skills for the cerebellar group, whereas verbal memory significantly predicted socialization skills for the third ventricle group. These findings suggest that cognitive predictors vary according to tumor location, and highlight the need for more research examining adaptive functioning and its correlates.     

Predictors of Cognitive Appraisals Following Genetic Testing for BRCA1 and BRCA2 Mutations

The objectives of this study were (1) to describe perceptions of stress and confidence following genetic testing for BRCA1 and BRCA2 (BRCA1/2) mutations and (2) to identify predictors of these processes. Participants were 130 high-risk women affected with cancer who received BRCA1/2 test results. Individual difference characteristics and interpersonal factors were measured by self-report before genetic counseling and perceptions of stress and confidence were evaluated by self-report 1 month following disclosure of test results. BRCA1/2 test results had a significant effect only on perceptions of stress (beta = 0.38, p = 0.0001), while trait anxiety had a significant effect on both perceptions of stress (beta = 0.44, p = 0.0001) and confidence (beta = -0.41, p = 0.001). These results suggest that interventions designed to address perceptions of stress related to medical decision-making and familial concerns may need to be targeted to BRCA1/2 mutation carriers and individuals who are highly anxious.