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Background As COVID-19 continues to spread globally, it is important to understand psychological factors that may influence compliance with social distancing. Purpose The present study examined whether Theory of Planned Behavior (TPB) constructs were associated with social distancing, with a focus on exploring moderators of the intention–behavior relationship. Methods Using a longitudinal design, U.S. adults (N = 507) self-reported TPB constructs and social distancing behavior at baseline and 3 months later. Participants were from 48 U.S. States and the District of Columbia and were on average 50.39 years old (SD = 15.32, range = 18–80). The majority were Non-Hispanic White (71.6%), had a bachelor’s degree or higher (55.3%), and resided in suburban areas (55.8%). Results While positive attitudes toward social distancing increased over time (p = .002), subjective norms weakened (p < .001) and perceived behavioral control (PBC) remained stable (p = .22). Interestingly, despite an increase in intentions from baseline to follow-up (p < .001), there was a significant decrease in social distancing behavior over time (p < .001). Consistent with the TPB, baseline attitudes (p < .001), subjective norms (p < .001), and PBC (p < .001) for social distancing were all associated with baseline intentions to social distance. In turn, baseline intentions were significantly associated with social distancing behavior at follow-up (p < .001). Younger adults (p < .001) and non-White participants (p = .002) displayed a greater intention–behavior gap relative to older and White participants. In contrast, participants with more stable intentions over time displayed a stronger intention–behavior relationship (p < .001). Conclusions Targeting individuals’ attitudes, norms, and PBC may effectively promote protective behaviors intended to mitigate the spread of COVID-19 and similar viral outbreaks. Future research should examine effective strategies for translating social distancing intentions into actions., Social distancing attitudes, norms, perceived behavioral control, and intentions were associated with social distancing behavior at 3-month follow-up. Racial minorities and younger adults displayed larger intention-behavior gaps.

The current study sought to identify subgroups of adult drinkers who differ in their level of association between alcohol-related Theory of Planned Behavior (TPB) constructs (attitudes, perceived norms, self-efficacy, and intentions), and explore if distinct subgroup profiles relate to alcohol use two weeks later.Participants (N = 121) were recruited to participate in a two-week study about daily experiences with exercise and alcohol (Alcohol attitudes, subjective norms, alcohol refusal self-efficacy, and intentions were used to create class membership. Behavioral outcomes included (1) drinking frequency, (2) drinking quantity, and (3) drinking to get drunk.Two classes of drinkers were determined - Class 1 was categorized by moderate scores on all constructs, whereas Class 2 was categorized by moderate scores on attitudes and high scores on norms, alcohol refusal self-efficacy, and intentions. Class designation was associated with frequency, but not quantity of use.The current study suggests that a minority of individuals who score moderately across all constructs should receive intervention efforts that focus on just those included in the TPB, while the vast majority may require additional constructs to be addressed.

Justice-involved youth are at a higher risk of negative outcomes from sexual activity and alcohol use relative to their non-justice involved peers. In the current study, we tested the extent to which variability in neurocognitive response (i.e., activation in the right superior parietal lobule; rSPL) during a risky decision-making task moderated the success of a sexual risk reduction intervention. In a cluster randomized trial blocked by gender, justice-involved adolescents (N = 269) first completed a risky decision-making task during a magnetic resonance imaging (MRI) session, then were assigned to an information-only control (GINFO) or sexual risk reduction intervention incorporating alcohol risk reduction content (GPI + GMET) and then re-contacted every three months for one year. Youth in the GPI + GMET intervention reported less sexual risk behavior 12 months after intervention than those in the control. Although neurocognitive activation was associated with sexual risk behavior, it did not moderate intervention outcomes. This risk-reduction intervention appears to work equally well across a range of neurocognitive responses.

Background In August 2019, the U.S. Food and Drug Administration proposed a set of 13 new graphic warnings for cigarette packaging and advertisements. Purpose We evaluated these warnings relative to text-only equivalents for their ability to educate the public regarding harms of smoking and influence outcomes associated with quitting. Methods In an experimental within-subjects design, U.S. adult nonsmokers, smokers, and dual smoker/electronic cigarette (e-cigarette) users (N = 412) recruited from an online internet platform evaluated the newly proposed graphic warnings and corresponding text-only warnings on understandability, perceived new knowledge, worry elicited about the content of the warning, discouragement from smoking, and encouragement to use e-cigarettes. Results Graphic warnings were generally rated as providing better understanding, more new knowledge, eliciting more worry about harms of smoking, and providing more discouragement from smoking relative to text-only warnings. Conclusions The newly proposed graphic warnings could influence important responses to warnings associated with motivation to reduce smoking.

Evidence supports the use of graphic warnings to educate the public about the health harms of smoking and suggests warnings eliciting negative emotional responses may be more effective. This study aimed to replicate a preliminary theory-based model whereby perceived new knowledge promotes discouragement from smoking through its impact on worry about smoking with a different sample and using a new set of cigarette graphic warnings. We explored if the pattern extended to encouragement to use e-cigarettes, and if age and user group moderated the indirect effects of these models. Exclusive smokers, dual/e-cigarette users and nonusers (N = 412) evaluated graphic cigarette warnings on perceived new knowledge and worry about health harms of smoking, discouragement to smoke, and encouragement to use e-cigarettes. Perceived new knowledge was both directly and indirectly associated with discouragement to smoke through worry about health harms of smoking, and did not vary as a function of age or user group. In contrast, perceived new knowledge was not directly or indirectly associated with encouragement to use e-cigarettes, and this pattern largely did not vary as a function of age or user group. Graphic cigarette warnings that enhance knowledge may discourage smoking both directly and indirectly through worry elicited by them, and may have less impact on encouraging e-cigarette use. These findings replicate prior work and generalize to different user groups and new warnings planned for implementation in the U.S.

This study aims to determine the rate of chronic pain in a community sample of young adult cannabis users, assess the extent to which pain relief is an important motivation for cannabis use, and explore differences in consumption patterns and problem behaviors between users with and without chronic pain. The study design was cross-sectional. Self-selected community-dwelling young adults (ages 18–29 years; n = 143) who regularly use cannabis completed an online survey. Results revealed that approximately 40% of the sample met the criteria for chronic pain, and pain relief was their primary motivation for use. There were no differences between groups with respect to frequency of use or estimated potency of their preferred strains; however, users with chronic pain reported using a wider variety of administration methods and a greater quantity of cannabis with each use. Users with chronic pain also reported more extensive histories of use, with younger age at initiation and longer duration of regular use. Despite riskier consumption patterns, there were no between-group differences in negative consequences owing to use after controlling for gender and educational status. On average, the total sample reported approximately 8 problems in the past 30 days owing to use. These findings suggest that chronic pain is commonly experienced among young adult cannabis users and pain relief is the primary motivation for users with pain. For some users, clinically significant chronic pain and pain-related interference persist despite heavy use. Cannabis users with and without chronic pain report experiencing several negative consequences owing to their use. Perspective This article compares motivations for cannabis use and describes differences in consumption patterns among a community sample of young adult users with and without chronic pain. This information may be useful for providers who assess and treat pain in young adults, particularly in settings that have legalized recreational use.

Public perception of marijuana is changing dramatically and anecdotal claims regarding the potential risks and benefits of marijuana use proliferate. These perceptions have implications for choosing to engage in marijuana use. The goal of this study was to describe perceptions of risks, benefits, and worry related to personal marijuana use and to identify the extent to which these beliefs were associated with marijuana use and problem severity. Further, we explored the extent to which individual perceived risk and worry items best predicted problem severity. Regular adult marijuana users (N = 96) completed assessments of their marijuana use, marijuana beliefs, and monitored their behavior over two weeks. Perceptions of risk and worry were low while perceptions of benefits were moderately high. Perceived risk and worry were positively associated with marijuana problem severity, but not marijuana use cross- sectionally or prospectively. Exploratory relative weight analyses indicated perceived risk and worry about negative mental health outcomes were most strongly associated with problem severity. Although users may experience problems, these do not seem to vary perceptions of benefits. As scientific support formarijuana’s risks and benefits increases, this information should be relayed to the public in order to correct misperceptions and prevent problems.

Strong health messages may result in reactance, increasing unhealthy behaviors. Reactance is purported to be derived of both cognitive and affective factors. The current study investigated the extent to which these cognitive and affective reactance components accounted for the link between message exposure on intentions and behavior. Emerging adults who never attended college (N = 244) completed an online study assessing anger and negative cognitions towards high or low threat anti-binge drinking messages. Intentions to drink and binge drink in the next week and drinking behaviors 1 week later were assessed. High threat messages elicited more anger and negative cognitions than low threat messages. High threat messages had a significant total indirect effect on intentions but had no effect on drinking behaviors. These outcomes suggest that while immediate cognitive and affect reactance has an effect on intentions, it may not influence longer-term decision making and may not outweigh benefits of strong messages.

The COVID-19 global pandemic is an unprecedented health threat for which behavior is critical to prevent spread and personal factors could contribute to decisions for protective action. The purpose of this study was to describe associations of COVID-19 related behaviors capturing a snapshot in time during the height of the first wave of the pandemic. We tested perceptions of likelihood and severity of infection, worry, and their associations with behavior. We further explored relationships by demographic characteristics, and tested main and interactive relationships between these characteristics and beliefs and protective behaviors. Using an online cross-sectional survey, U.S. adults (N = 795) reported their perceptions of likelihood and severity of, and worry about, contracting COVID-19 for self and others, and engagement in protective behaviors. In bivariate tests, all cognitive and affective beliefs were positively associated with hygiene behaviors, but only worry and personal and others’ severity were associated with greater likelihood of social distancing. Controlling for other beliefs and demographic factors, perceived personal severity remained associated with social distancing, and worry with hygiene behaviors. How people think and feel about risk could have implications for communicating information about this novel health threat and motivating action to mitigate its spread. Supplementary Information The online version contains supplementary material available at 10.1007/s10865-021-00202-4.

Smokeless tobacco use among Indian women is increasing despite prevention efforts. Evolutionary theories suggest that reproductive-aged women should be more concerned about immediate threats to reproduction than threats to survival occurring late in life. This study therefore compared an anti-tobacco intervention that emphasized near-term reproductive harms to one involving general harms occurring later in life. Scheduled Tribal women (N = 92) from Karnataka, India participated in this study. At baseline, women reported tobacco use and knowledge of harms, provided a saliva sample to assess use, and randomly viewed either a general harms presentation (GHP) or reproductive harms presentation (RHP). At followup, women reported their use, knowledge of harms and intentions to quit, and provided another saliva sample. At baseline, participants were aware of general harms but not reproductive harms. Both interventions increased knowledge of harms. Women in the RHP condition did not list more harms than women in the GHP condition, however, and the RHP was not more effective in reducing tobacco use than the GHP. In the RHP condition fetal health was particularly salient. In the GHP condition, oral health was highly salient, aligning with the local disease ecology and research on tobacco use and attractiveness., Media summary: Providing information on tobacco’s reproductive harms might reduce tobacco use among Scheduled Tribal women in India.

Objective: This experiment examined whether people respond differently to information about where they stand relative to peer behaviour or to expert behavioural recommendations, and whether respons...

INTRODUCTION: Justice-involved adolescents are at high risk for sexually transmitted infections; one primary reason is co-occurring substance use. This study investigates the additive benefit of including alcohol and cannabis use content to a theory-based sexual risk reduction intervention, delivered using group-based motivational enhancement therapy. STUDY DESIGN: This study had a cluster randomized design, with randomization of single-sex clusters to one of three interventions. SETTING/PARTICIPANTS: Participants were male and female justice-involved adolescents (N=460) residing in youth detention facilities. Data were collected from 2010 to 2014; analyses were completed in 2018–2019. INTERVENTION: Adolescents were randomized to one of three motivational enhancement therapy interventions: sexual risk reduction intervention, sexual risk reduction intervention with alcohol content, or sexual risk reduction intervention with alcohol and cannabis content. MAIN OUTCOME MEASURES: The primary outcome was risky sexual behavior (aggregation of condom use and frequency of intercourse), measured every 3 months for 1 year. Secondary outcomes were theoretical mechanisms on which the intervention was based (condom use attitudes, self-efficacy, peer norms, and behavioral intentions), collected at baseline and post-test. RESULTS: Risky sexual behavior significantly decreased from baseline to 3-month follow-up (t=10.59, p0.29 for all). Comparisons to a historical information-only, sexual risk reduction control arm conducted with a similar juvenile justice sample confirm effectiveness of all three motivational enhancement therapy–based interventions. CONCLUSIONS: All three interventions were associated with decreased sexual risk up to 1 year later, suggesting that the intervention modality (motivational enhancement therapy) may resonate with this population beyond the specific substance use content. This single-session manualized intervention can be readily disseminated to juvenile justice settings. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01170260.

Because adolescence is a period of heightened exploration of new behaviors, there is a natural increase in risk taking including initial use of alcohol and marijuana. In order to better understand potential differences in neurocognitive functioning among adolescents who use drugs, the current study aimed to identify the neural substrates of risky decision making that differ among adolescents who are primary users of alcohol or marijuana, primary users of both alcohol and marijuana, and controls who report primary use of neither drug. Participants completed the Balloon Analogue Risk Task (BART) while undergoing functional magnetic resonance imaging. Comparison of brain activation during risky decisions versus non-risky decisions across all subjects revealed greater response to risky decisions in dorsal anterior cinguate cortex (dACC), anterior insula, ventral striatum, and lateral prefrontal cortex. Group comparisons across non-using controls, primary marijuana, primary alcohol, and alcohol and marijuana users revealed several notable differences in the recruitment of brain regions. Adolescents who use both alcohol and marijauna show decreased response during risky decision making compared to controls in insula, striatum, and thalamus, and reduced differentiation of increasing risk in dACC, insula, striatum, and superior parietal lobe compared to controls. These results provide evidence of differential engagement of risky decision making circuits among adolescents with varying levels of alcohol and marijuana use, and may provide useful targets for longitudinal studies that explicitly address causality of these differences.

OBJECTIVE Although graphic cigarette warnings have important benefits that may aid in motivating smoking quit attempts and discouraging smoking initiation, 1 possible negative consequence might be psychological reactance to graphic warnings. Reactance to warnings might be shaped by stereotypical views of smokers. This research examined the associations of positive and negative smoker stereotypes with perceptions of the educational value of warnings as well as affective and motivational responses to them. METHOD Using a cross-sectional design, young adult smokers and nonsmokers (N = 396) completed an online questionnaire assessing positive and negative smoker stereotypes and then evaluated a series of graphic-plus-text and text-only cigarette warnings on perceived new knowledge gained from the warning, understandability of the warning, worry about the consequences of smoking elicited by the warning, and discouragement from smoking elicited by the warning. RESULTS Negative smoker stereotypes were associated with all warning perceptions-more negative stereotypes were associated with higher levels of perceived new knowledge, perceived understandability, worry, and discouragement from smoking. Positive smoker stereotypes were only associated with more perceived new knowledge. Neither smoking status nor warning type moderated the relationships between smoking stereotypes and warning evaluations. CONCLUSIONS Focusing on enhancing negative smoker portrayals, rather than reducing positive portrayals, may be more effective for antismoking campaigns. (PsycINFO Database Record

Background Chronic alcohol abuse is related to numerous deleterious neurobiological consequences, including loss of gray matter, damage to white matter (WM), and impairment of cognitive and motor functions. Aerobic exercise has been demonstrated to slow cognitive decline and decrease the negative neural changes resulting from normal aging and from several diseases. It is possible that exercise may also prevent or repair alcohol-related neurological damage. This study tested the hypothesis that aerobic exercise protects WM in anterior and dorsal areas of the brain from damage related to heavy alcohol use. Methods Sixty individuals underwent a diffusion tensor imaging session and completed measures of alcohol consumption, loss of control over drinking, and aerobic exercise participation. Analyses examined the relationship of exercise, alcohol, and their interaction to fractional anisotropy (FA) in the superior longitudinal fasciculus (SLF), external capsule (EC), superior and anterior corona radiata, and fornix. The relationship of aerobic exercise and alcohol consumption to self-reported loss of control over drinking were also examined. Results A significant interaction was observed between alcohol consumption and aerobic exercise participation on FA in the SLF and EC. In the models examining loss of control over drinking, a significant interaction between aerobic exercise and alcohol consumption was observed, such that alcohol consumption was associated with loss of control more strongly for low exercisers than high exercisers. Conclusions These results indicate that the association between heavy alcohol consumption and WM damage in the EC and SLF and the association between alcohol consumption and loss of control over drinking are greater among individuals who do not exercise regularly. These results are consistent with the notion that exercise may protect WM integrity from alcohol-related damage.

Affective responses during exercise are often important determinants of exercise initiation and maintenance. Current physical activity may be one individual difference that is associated with the degree to which individuals have positive (or negative) affective experiences during exercise. The objective of this study was to explore physical and cognitive explanations of the relationship between current activity status (more versus less active) and affective response during a 30-minute bout of moderate-intensity exercise. Participants reported their current level of physical activity, exercise self-efficacy and affect during a 30-minute bout of moderate-intensity exercise. More active individuals experienced higher levels of positive affect and tranquillity and lower levels of negative affect and fatigue during exercise. Multivariate models for each affective state indicated separate processes through which physical activity may be associated with changes in affect during exercise. These models indicate that affect experienced during physical activity is related to the current activity level and these relationships can be partially explained by the physical and cognitive factors explored in this study. Recommendations for future research to elucidate whether positive affective response to physical activity improves as a function of becoming more active over time are discussed.

In two studies, we examined nonsmokers' perceptions of smokers and consequences of the perceptions. In Study 1, smokers answered questions about their sense of self, dependence on smoking, and motivation to quit. Nonsmokers answered questions about their perceptions of these characteristics. Differences between smokers' self-descriptions and nonsmokers' perceptions were observed. Study 2 asked nonsmokers to judge two types of smokers for which the descriptions were based on Study 1 findings. Results showed that nonsmokers held a more negative attitude about and were less willing to engage in different close relationships with the smoker who was described in terms of nonsmokers' perceptions rather than smokers' reports. Attitude mediated the relationship between type of smoker and willingness to date a smoker.

Individuals who exercise are at lower risk for breast cancer and have better post-diagnosis outcomes. The biological mechanisms behind this association are unclear, but DNA methylation has been suggested.We developed a composite measure of DNA methylation across 45 CpG sites on genes selected a priori. We examined the association of this measure to self-reported physical activity and objectively measured cardiovascular fitness in a sample of healthy nonsmoking adults (n = 64) in an exercise promotion intervention.Individuals who were more physically fit and who exercised more minutes per week had lower levels of DNA methylation. Those who increased their minutes of physical activity over 12 months experienced decreases in DNA methylation.DNA methylation may be a mechanism linking exercise and cancer incidence and could serve as a biomarker for behavioral intervention trials. Studies with larger samples, objectively measured exercise, and more cancer-related markers are needed.

Adolescents involved with the juvenile justice system have a high incidence of risky sexual behaviors resulting in unintended pregnancy and sexually transmitted infections. Substance use may be particularly important as a risk factor for unsafe sexual behavior for this group, and recent evidence suggests a possible association between marijuana use and risky sexual behavior. Adolescents (n = 728; 33% female) on probation were followed for 2 years, at intervals of 6 months, to explore the association of marijuana use and condom use longitudinally and at a specific intercourse occasion. Latent growth curve modeling indicated that greater marijuana use at baseline was associated with a steeper decline in condom use over the 2-year period of the study. In-depth analysis of the most recent intercourse occasion suggested that condom use was less likely if marijuana was being used by the participant or his/her partner and that this association was more pronounced if intercourse occurred with someone the participant had just met. Implications for the prevention of risky sexual behavior in this population are discussed.

A transdisciplinary approach incorporating biological, psychological, behavioral, and genetic factors was taken to better identify proposed moderators of the effectiveness of an intervention to increase physical activity. This paper illustrates how theory-based individual difference variables can be integrated into a complex randomized controlled trial. The transdisciplinary framework guiding the selection of moderators, the COSTRIDE intervention study and sample, and the relationships among baseline variables are provided. Participants were non-active individuals randomly assigned to either the STRIDE exercise or health-and-wellness contact control condition. Structural equation modeling was utilized to demonstrate that relationships among baseline variables confirm hypothesized relationships in the transdisciplinary framework. Preliminary data from COSTRIDE suggest that interventions among sedentary individuals may be more effective if a broader range of factors influencing physical activity are considered.

According to self-determination theory, a tendency to view causes of a behavior as autonomous, controlled, or impersonal can influence motivation, self-regulation, and experience. We propose that causality orientations for exercise may shape self-determined regulations for exercise by leading to more positive exercise-related affect, leading to greater internalization of exercise behavior and more self-determined regulations to exercise (e.g., regulation on the basis of inherent interest and personally-held values). METHODS: Participants (N = 104) kept an online diary for four weeks documenting exercise behavior and affect experienced during exercise. Exercise causality orientations were measured at baseline and exercise regulations were measured at follow-up. Analyses were performed using multilevel modeling and path analysis. RESULTS: Exercise-related affect was more positive for those with higher levels of the autonomy orientation and lower levels of the impersonal orientation. Exercise-related affect partially mediated the relationship between autonomy and impersonal orientations and self-determined regulations for exercise. CONCLUSIONS: Affective responses to self-selected exercise were more positive for those who tend to perceive exercise opportunities as more autonomous, which in turn led to more self-determined regulations.

Objectives The goal of this research is to utilize a transdisciplinary framework to guide the selection of putative moderators of the effectiveness of an intervention to promote physical activity behavior adoption and maintenance. Effective interventions to increase physical activity are sorely needed, and one barrier to the identification and development of such interventions is the lack of research targeted at understanding both the mechanisms of intervention efficacy and for whom particular interventions are effective. Design We demonstrate the utilization of important individual difference moderators in the context of a randomized controlled intervention trial. Methods We outline our transdisciplinary approach to understanding individual differences in the effectiveness of a previously successful exercise promotion intervention. Results We explain the rationale for and operationalization of our framework, characteristics of the study to which we apply the framework, and planned analyses. Conclusion By embracing a transdisciplinary orientation for individual differences important in the prediction of physical activity (spanning molecular approaches, animal models, human laboratory models, and social psychological models), we hope to have a better understanding of characteristics of individuals that are important in the adoption and maintenance of physical activity.

Importance Adolescents in the juvenile justice system are at high risk for sexually transmitted infections (STIs). Concurrent use of alcohol and cannabis increase this risk. Objective To determine whether a theory-based sexual risk-reduction intervention that included alcohol- and cannabis-focused content resulted in greater reductions in STIs than an intervention that included alcohol-related content only and an intervention that did not include substance use content. Design, Setting, and Participants Cluster randomized clinical trial with 3 conditions. Between July 1, 2010, and December 10, 2014, adolescents living at a juvenile detention facility in the southwestern United States were tested and treated for STI before randomization and again 12 months after the intervention. Data analyses were conducted in July and August 2017. Eligibility criteria included (1) being aged 14 to 18 years, (2) able to speak English, (3) having a remaining detention term of less than 1 month, and (4) signing a release granting access to STI results if tested at intake. Six hundred ninety-three adolescents were assessed for eligibility. Of these, 460 completed baseline assessments and were randomized to 1 of 3 intervention conditions. Data analysis was by intent-to-treat. Interventions There were 3 intervention conditions: sexual risk reduction intervention (SRRI); SRRI plus alcohol content (SRRI + ETOH); and SRRI + ETOH plus cannabis content (SRRI + ETOH + THC). Interventions were conducted in same-sex groups by trained clinicians and included video presentations with discussion, group activities, and active feedback by participants, consistent with the principles of motivational enhancement therapy. Main Outcomes and Measures Although not the outcome on which the study was originally powered, the main outcome variable presented herein is STI incidence (Chlamydia trachomatisand/orNeisseria gonorrhoeae) 12 months after the intervention. Results Of the 460 participants randomized, mean (SD) age was 15.8 (1.1) years, 347 participants (75.4%) were male, and 57.0% were of Hispanic ethnicity. Among the participants, 143 were randomized to SSRI, 155 to SRRI + ETOH, and 162 to SRRI + ETOH + THC. Attrition at 12-month follow-up was 99 (21.5%) for the STI outcome variable. Participants in the SRRI + ETOH + THC intervention had lower incidence of STI at follow-up (3.9%) than those in either the SRRI (12.4%; odds ratio, 0.29; 95% CI, 0.10-0.84) or the SRRI + ETOH (10.2%; odds ratio, 0.36; 95% CI, 0.12-1.05) interventions. Conclusions and Relevance An intervention delivered in a motivational enhancement therapy format that includes theory-based sexual risk reduction combined with alcohol- and cannabis-focused elements is effective at reducing STI incidence among justice-involved adolescents. This 1-session manualized intervention can be delivered in the context of short-term detention and is easily disseminated to juvenile justice agencies. Trial Registration clinicaltrials.gov Identifier:NCT01170260

Objective The purpose of this study was to investigate smokers' thoughts and worries about their smoking behavior. Researchers have sometimes asked smokers to make such self-assessments but typically using retrospective summary judgments. Design Using ecological momentary assessment, community and student smokers reported five times daily during two separate 1-week intervals. Main outcome measures Smokers reported their thoughts about smoking, worries about smoking, and level of contemplation to quit smoking. Results Smokers reported thinking negatively about their smoking 26.8% of the time they had a cigarette. The most frequent thoughts reported by smokers related to immediate reinforcement of smoking (e.g., "How I smell like cigarettes"). However, smokers reported more intense worry about thoughts related to health concerns (e.g., "Symptoms I'm having because of smoking"). The occurrence of negative thoughts was significantly and positively related to contemplation about quitting, worry about smoking, and risk perceptions. Finally, self-reported worry intensity was more strongly related to contemplation of quitting than negative thought occurrence. Conclusion Our results show that thoughts about smoking (i.e., cognitions) and feelings about smoking (i.e., worry) are loosely connected and it is feelings rather than cognitions that are most related to contemplation to quit.

When researchers communicate the negative health risks of smoking, smokers are likely to minimize such effects. This experiment addressed a way to reduce this defensiveness: allowing smokers to affirm aspects of the self. Smokers (n= 100) and nonsmokers (n= 30) viewed eight health-warning messages about smoking. Smokers were randomly assigned to view (a) warnings without a self-affirmation manipulation, (b) warnings after a self-affirmation manipulation, or (c) warnings that had a positive self-statement attached to it. Analyses indicated that compared to nonsmokers, no-affirmation smokers rated the warning messages as: (a) communicating less serious consequences, (b) less accurate, and (c) less likely to influence smokers. However, compared to no-affirmation smokers, smokers who affirmed the self were no more likely to rate the messages as serious, accurate, or effective. These data suggest that affirming the self before, or using a self-affirmation within a warning message may not encourage smokers to be more accepting of risk information.

Although much research on graphic cigarette warnings has focused on motivational responses, little focus has been given to how much individuals learn from these labels. This study aims to investigate whether graphic warnings provide greater perceived new knowledge of smoking consequences compared to text-only warnings, and to test a mediational model whereby perceived new knowledge promotes discouragement from smoking through its impact on worry. In two studies, young adult smokers and nonsmokers (ages 18–25) evaluated graphic + text and corresponding text-only labels on perceived knowledge, worry about the harms addressed by the warning, and discouragement from smoking. Compared to text-only labels, graphic + text labels were rated as providing better understanding, more new knowledge, and being more worrisome and discouraging. Perceived new knowledge predicted greater discouragement from smoking directly and through worry. Graphic warnings may be more efficacious than text-based warnings in increasing knowledge and worry about harms, and discouragement from smoking.

A common criticism of social cognitive models predicting health behavior is their exclusion of affect—an important component of individual-level decision processes for behavior change. Yet the role of affect, and its interaction with cognitions, is complex. We provide an overview of affect and pathways through which it is proposed to influence outcomes. Then, we discuss several common social cognitive models of health behavior change. Next, we highlight specific affect-laden constructs (those that incorporate affective and cognitive components) related to health behavior change. We aim to provide clarity on terminology and measurement of the affect-laden constructs and evidence associating them with health behavior. Finally, we discuss strategies for incorporating these constructs within popular cognitive-based theories and provide suggestions for future work.

Juvenile justice involved youth are at great risk for negative outcomes of risky sexual behavior including HIV/AIDS. Given the strong connection between alcohol use and risky sex in this population, it is important to consider alcohol use in interventions designed to decrease risky sexual behavior. This paper provides support for an integrative translational model that incorporates psychosocial, neurobiological, and genetic factors to better predict alcohol-related sexual risk behavior. Specifically, we present the design, methods, and baseline data from a complex randomized control trial, Project SHARP (Sexual Health and Adolescent Risk Prevention) in order to illustrate how this broad array of factors can best predict alcohol-related sexual risk behavior. Participants were justice-involved adolescents (n=284) who completed an fMRI and self-report assessments prior to randomization to either a sexual risk plus alcohol risk reduction group intervention or to an information-only contact control group intervention. Structural equation modeling was utilized and findings supported the hypothesized relationships in the translational model. Preliminary data suggest that interventions among justice-involved adolescents targeting alcohol-related sexual risk behavior may be more effective if a biopsychosocial approach is considered.

The current study examined the relationships among marijuana dependence, a theoretical model of condom use intentions, and subsequent condom use behavior in justice-involved adolescents. Participants completed baseline measures of prior sexual and substance use behavior. Of the original 720 participants, 649 (90.13 %) completed follow-up measures 6 months later. There were high levels of marijuana use (58.7 % met criteria for dependence) and risky sexual behavior among participants. Baseline model constructs were associated with condom use intentions, and intentions were a significant predictor of condom use at follow-up. Marijuana dependence did not significantly influence the relationships between model constructs, nor did it moderate the relationship of model constructs with subsequent condom use. Findings suggest that the theoretical model of condom use intentions is equally valid regardless of marijuana dependence status, suggesting that interventions to reduce sexual risk behavior among both marijuana dependent and non-dependent justice-involved adolescents can be appropriately based on the model.

In two studies, we examined nonsmokers’ perceptions of smokers and consequences of the perceptions. In Study 1, smokers answered questions about their sense of self, dependence on smoking, and motivation to quit. Nonsmokers answered questions about their perceptions of these characteristics. Differences between smokers’ self-descriptions and nonsmokers’ perceptions were observed. Study 2 asked nonsmokers to judge two types of smokers for which the descriptions were based on Study 1 findings. Results showed that nonsmokers held a more negative attitude about and were less willing to engage in different close relationships with the smoker who was described in terms of nonsmokers’ perceptions rather than smokers’ reports. Attitude mediated the relationship between type of smoker and willingness to date a smoker.

Marijuana and alcohol use are associated with increased sexual risk behavior among justice-involved youth. A multi-behavior intervention may reduce all three risk behaviors. The purpose of this study is to examine the relationships among multiple risk behaviors and the Theory of Planned Behavior (TPB) constructs guiding the development of the Motivating Adolescents to Reduce Sexual risk (MARS) intervention. We describe the MARS study design to inform the process through which a multi-behavior intervention trial can be implemented and evaluated. Participants completed questionnaires prior to randomization to one of three interventions. Relationships were found between TPB constructs and risk behavior. A single latent variable was inadequate to capture all three risk behaviors. Interventions to reduce sexual risk behavior can include content related to the role of substance use in influencing sexual risk behavior with only minimal modifications to the curriculum, and preliminary data suggest a common theory can apply across risk behaviors.

Juvenile justice involved youth are at great risk for negative outcomes of risky sexual behavior including HIV/AIDS. Given the strong connection between alcohol use and risky sex in this population, it is important to consider alcohol use in interventions designed to decrease risky sexual behavior.This paper provides support for an integrative translational model that incorporates psychosocial, neurobiological, and genetic factors to better predict alcohol-related sexual risk behavior. Specifically, we present the design, methods, and baseline data from a complex randomized control trial, Project SHARP (Sexual Health and Adolescent Risk Prevention) in order to illustrate how this broad array of factors can best predict alcohol-related sexual risk behavior. Participants were justice-involved adolescents (n=284) who completed an fMRI and self-report assessments prior to randomization to either a sexual risk plus alcohol risk reduction group intervention or to an information-only contact control group intervention. Structural equation modeling was utilized and findings supported the hypothesized relationships in the translational model. Preliminary data suggest that interventions among justice-involved adolescents targeting alcohol-related sexual risk behavior may be more effective if a biopsychosocial approach is considered.

Using ecological momentary assessment (EMA), we sought to determine whether differences in reporting would exist for smokers who self-monitored their smoking-related negative thoughts five times daily in comparison to a non-EMA control group. One hundred and seventeen smokers were randomly assigned to two conditions. Eighty-eight smokers carried personal digital assistants (PDAs) for two weeks and monitored negative thoughts each day and 29 smokers did not self-monitor their negative thoughts. All smokers completed pretest and posttest assessments reporting their perceived risk and worry associated with smoking consequences. The data revealed evidence of self-monitoring effects, as smokers in the EMA condition reported less worry after two weeks of self-monitoring compared to smokers in the control condition. The two conditions did not differ in their reports of perceived risk of smoking consequences. These data suggest that EMA procedures asking respondents to self-monitor their thoughts about smoking may influence feelings about their smoking behavior.

Background:Maximal oxygen uptake (VO2max), an assessment of cardiorespiratory fitness, is regularly used as the primary outcome in exercise interventions. Many criteria have been suggested for validating such tests—most commonly, a plateau in oxygen consumption. The current study investigated the proportion of inactive individuals who reached a plateau in oxygen uptake and who achieved a valid test as assessed by secondary criteria (RERmax ≥ 1.1; RPEmax ≥ 18; age predicted HRmax ±10bpm), and the correlates of a successful plateau or achievement of secondary criteria during a VO2max session.Methods:Participants (n = 240) were inactive individuals who completed VO2max assessments using an incremental treadmill test. We explored physical, behavioral, and motivational factors as predictors of meeting criteria for meeting a valid test.Results:Approximately 59% of the sample achieved plateau using absolute (increase of VO2 of 150ml O2 or less) and 37% achieved plateau using relative (increase of VO2 of 1.5ml/kg O2 or less) criteria. Being male, having a higher BMI, a greater waist-to-hip ratio, and increased self-efficacy were associated with lower odds of achieving an absolute plateau, whereas none of these factors predicted odds of achieving relative plateau.Conclusion:Findings raise questions about the validity of commonly used criteria with less active populations.

This report discusses a study which aimed to test a hypothesis related to condom use - that ecological cues for the presence of pathogens would increase intentions to use condoms. It describes the method and the results of this experiment which included 99 undergraduate psychology students. It states that this study suggests that motivational systems influencing condom use may respond to cues for general pathogen threats and that sensory systems evolved to detect pathogen threats may influence intentions to use condoms in a different manner than do verbal communications of sexually transmitted disease threat.

Multiple studies suggest an association of marijuana use with increased rates of sexual risk behavior and sexually transmitted diseases (STDs). Most studies have focused on global associations of marijuana use with sexual risk outcomes and few have examined relevant cognitive variables. Adolescents in the juvenile justice system are at elevated risk for HIV/STDs and preliminary evidence suggests that marijuana is a potentially important cofactor for sexual risk behavior in this population. This study evaluated global, situational and event-level associations of marijuana use and sex-related marijuana expectancies with sexual risk outcomes in a large, racially diverse sample of adjudicated youth (n = 656, 66% male, mean age = 16.7 years). Cross-sectional and prospective analyses identified associations of marijuana use and dependence symptoms with sexual risk outcomes, including lower frequency of condom use and higher STD incidence. Stronger sex-related marijuana expectancies predicted greater intentions for and frequency of marijuana use in sexual situations. In event-level analyses that controlled for alcohol, marijuana use predicted a significantly decreased likelihood of condom use; this association was moderated by sex-related marijuana expectancies. Mediation analyses suggested that behavioral intentions partly accounted for the prospective association of expectancies with marijuana use before sex. These results provide further evidence that marijuana use is a potentially important cofactor for HIV/STD transmission in high-risk adolescents and suggest that cognitive factors could be important for characterizing this association.

Research concerning motives for smoking cessation has focused on beliefs (cognitions) that people have, especially risk perceptions, with less attention directed to worry (negative affect) concerning one's smoking.We tested a manipulation to encourage smokers to think and worry more about their smoking behavior. We contrasted risk perceptions and worry as predictors of contemplation to quit smoking.Smokers were randomly assigned to two conditions in which they carried personal digital assistants for 2 weeks. When signaled, smokers read smoking consequence statements or daily hassle statements.After 2 weeks, experimental smokers reported greater perceived risk and worry about developing a medical condition compared to control smokers. Both perceived risk and worry independently mediated the relationship between the experimental manipulation and increased contemplation to quit smoking; however, worry was the strongest mediator in a multiple mediation model.Worry may be foremost for motivating smokers to attempt quitting.

Objective: Accurate measurement of beliefs about risk probability is essential to determine what role these beliefs have in health behavior. This study investigated the ability of several types of risk perception measures and of other constructs from health behavior theories to predict influenza vaccination. Design: Prospective study in which students, faculty, and staff at 3 universities (N 428) were interviewed in the fall, before influenza vaccine was available, and again early in the next calendar year. Main Outcome Measure: Self-reported influenza vaccination. Results: Two interview questions that asked about feeling at risk and feeling vulnerable predicted subsequent behavior better (r .44, p .001) than 2 questions that asked for agreement or disagreement with statements about risk probability (r .25, p .001) or 4 questions that asked respondents to estimate the magnitude of the risk probability (r .30, p .001). Of the 4 perceived risk magnitude scales, a 7-point verbal scale was the best predictor of behavior. Anticipated regret was the strongest predictor of vaccination (r .45, p .001) of all constructs studied, including risk perceptions, worry, and perceived vaccine effectiveness. Conclusion: Risk perceptions predicted subsequent vaccination. However, perceived risk phrased in terms of feelings rather than as a purely cognitive probability judgment predicted better. Because neither feeling at risk nor anticipated regret is represented in the most commonly used theories of health behavior, the data suggest that these theories are missing important constructs.

Adolescence is a unique developmental period of exploration and risk, yet because regions of the brain most able to weigh consequences and self-regulate in tempting situations are still developing, many of the behaviors “typical” to adolescent exploration (e.g., alcohol use, sexual behavior) can have serious negative consequences. Youth under age 25 …