Effects of goal difficulty and temporality in motor skill acquisition using the Bachman ladder

The effects of different types of goal setting on motor skill learning were investigated. 100 individuals (64 men, 36 women) without experience in the performance of the Bachman ladder task participated. Participants were randomly assigned to one of five goal groups: (a) generic, (b) long-term, difficult, (c) long-term, easy; (d) short- and long-term, difficult, and (e) short- and long-term, easy. In the acquisition phase, participants performed 200 trials, and in the transfer and retention phases, each performed 50 trials. The dependent variable was the number of steps achieved in blocks of 10 trials. The results showed that the groups had similar performances in both the transfer and retention phases. Setting of generic, difficult, easy, long- and short-term, and self-setting goals all enabled similar effects on motor learning.

Using household survey data to inform policy decisions regarding the delivery of evidence-based parenting interventions.

Background: This study used household survey data on the prevalence of child, parent and family variables to establish potential targets for a population-level intervention to strengthen parenting skills in the community. The goals of the intervention include decreasing child conduct problems, increasing parental self-efficacy, use of positive parenting strategies, decreasing coercive parenting and increasing help-seeking, social support and participation in positive parenting programmes. Methods: A total of 4010 parents with a child under the age of 12 years completed a statewide telephone survey on parenting. Results: One in three parents reported that their child had a behavioural or emotional problem in the previous 6 months. Furthermore, 9% of children aged 2–12 years meet criteria for oppositional defiant disorder. Parents who reported their child's behaviour to be difficult were more likely to perceive parenting as a negative experience (i.e. demanding, stressful and depressing). Parents with greatest difficulties were mothers without partners and who had low levels of confidence in their parenting roles. About 20% of parents reported being stressed and 5% reported being depressed in the 2 weeks prior to the survey. Parents with personal adjustment problems had lower levels of parenting confidence and their child was more difficult to manage. Only one in four parents had participated in a parent education programme. Conclusions: Implications for the setting of population-level goals and targets for strengthening parenting skills are discussed.

Insufficiently active Australian college students: Perceived personal, social, and environmental influences

Background. A sustainable pattern of participation in physical activity is important in the maintenance of health and prevention of disease, College students are in transition from an active youth to a more sedentary adult behavior pattern. Methods. We assessed self-reported physical activity and other characteristics in a sample of 2,729 male and female students (median age was 20 years) recruited from representative courses and year levels at four Australian College campuses. They were categorized as sufficiently or insufficiently active, using estimates of energy expenditure (kcal/week) derived from self-reported physical activity, Personal factors (self-efficacy, job status, enjoyment), social factors (social support from family/friends), and environmental factors (awareness of facilities, gym membership) were also assessed. Results. Forty-seven percent of females and 32% of males were insufficiently active. For females, the significant independent predictors of being insufficiently active were lower social support from family and friends, lower enjoyment of activity, and not working. For males, predictors were lower social support from family and friends, lower enjoyment of activity, and being older. Conclusions. Factors associated with physical activity participation (particularly social support from family and friends) can inform physical activity strategies directed at young adults in the college setting. (C) 1999 American Health Foundation and Academic Press.

Attachment style as a predictor of sexual attitudes and behavior in late adolescence

This research applied attachment theory to the study of sexual attitudes and behaviors in a sample of late adolescents. Four hundred and seventy heterosexual undergraduate students completed questionnaires assessing attachment (discomfort with closeness; anxiety over relationships), relationship history, communication about sex, sexual self-efficacy and locus of control, and attitudes to condoms. Eight weeks later, participants reported on sexual behaviors occurring during the eight-week interval, and perceived risk of these activities. Both discomfort with closeness and anxiety over relationships were associated with external locus of control for sexual outcomes, and with use of drugs before sexual contact. Anxiety over relationships was linked to unsafe sex and to negative attitudes to condoms, but discomfort with closeness was associated with a more cautious approach to sexual risk-taking. Some results were qualified by gender differences, and by differences between the full sample and those who were sexually active. The findings are discussed in terms of attachment style and its links with communication and affect regulation.

Social-cognitive and perceived environment influences associated with physical activity in older Australians

Background, Regular physical activity in older adults can facilitate healthy aging, improve functional capacity, and prevent disease. However, factors associated with physical inactivity in older populations are poorly understood. This study attempts to identify social-cognitive and perceived environmental influences associated with physical activity participation in older populations. Methods. In a randomly selected sample of 449 Australian adults age 60 and older, we assessed self-reported physical activity and a range of social-cognitive and perceived environmental factors. Respondents were classified as sufficiently active and inactive based on energy expenditure estimates (kcal/week) derived from self-reported physical activity. Two logistic regression models, with and without self-efficacy included, were conducted to identify modifiable independent predictors of physical activity. Results. Significantly more males than females were physically active. Physical activity participation was related to age with a greater proportion of those age 65-69 being active than those age 60-64 or 70 or older. High self-efficacy, regular participation of friends and family, finding footpaths safe for walking, and access to local facilities were significantly associated with being active. Conclusion. Identifying predictors of physical activity in older populations, particularly social support, facility access, and neighbourhood safety, can inform the development of policy and intervention strategies to promote the health of older people. (C) 2000 American Health Foundation and Academic Press.

Career versus motherhood? A case study describing a cognitive-existential approach to the dilemma

The present paper reports a case study concerning a professional woman in her 30s, who presented to the Occupational Health department of a metropolitan hospital with work stress stemming from accelerating work demands and marital problems related to the decision about whether to start a family or continue her career. No clinical diagnosis was warranted; however, Maslach Burnout Inventory Scores indicated a high degree of emotional exhaustion and moderate levels of depersonalisation, offset by a high sense of personal accomplishment in her work role. The client also demonstrated severe stress and moderate depression on the Depression-Anxiety-Stress Scale (DASS-21). The case was conceptualised from a combined cognitive-existential perspective. The woman's cognitions about her work, relationship, and prospective motherhood roles were identified, as well as underlying existential issues such as finding a meaning in life and a fear of being alone and unloved. Eight sessions of therapy incorporated components of cognitive and existential therapies, aimed at managing stress and improving marital adjustment. Posttreatment results showed substantial reductions in all the measures of distress, while personal accomplishment remained high. The woman and her husband decided to defer starting a family until other issues had been addressed.

Breastfeeding duration in an Australian population: The influence of modifiable antenatal factors

Despite well-documented health benefits of breastfeeding for mothers and babies, most women discontinue breastfeeding before the recommended 12 months to 2 years. The purpose of this study was to assess the effect of modifiable antenatal variables on breastfeeding outcomes. A prospective, longitudinal study was conducted with 300 pregnant, Australian women. Questionnaires containing variables of interest were administered to women during their last trimester; infant feeding method was assessed at I week and 4 months postpartum. Intended breastfeeding duration and breastfeeding self-efficacy were identified as the most significant modifiable variables predictive of breastfeeding outcomes. Mothers who intended to breastfeed for < 6 months were 2.4 times as likely to have discontinued breastfeeding at 4 months compared to those who intended to breastfeed for > 12 months (35.7% vs 87.5%). Similarly, mothers with high breastfeeding self-efficacy were more likely to be breastfeeding compared to mothers with low self-efficacy (79.3% vs 50.0%).

Depression: a predictor of smoking relapse in a 6-month follow-up after hospitalization for acute coronary syndrome

Objective The objective of the study was to investigate whether depression is a predictor of postdischarge smoking relapse among patients hospitalized for myocardial infarction (MI) or unstable angina (ILIA), in a smoke-free hospital. Methods Current smokers with MI or UA were interviewed while hospitalized; patients classified with major depression (MD) or no humor disorder were reinterviewed 6 months post discharge to ascertain smoking status. Potential predictors of relapse (depression; stress; anxiety; heart disease risk perception; coffee and alcohol consumption; sociodemographic, clinical, and smoking habit characteristics) were compared between those with MD (n = 268) and no humor disorder (n = 135). Results Relapsers (40.4%) were more frequently and more severely depressed, had higher anxiety and lower self-efficacy scale scores, diagnosis of UA, shorter hospitalizations, started smoking younger, made fewer attempts to quit, had a consort less often, and were more frequently at the `precontemplation` stage of change. Multivariate analysis showed relapse-positive predictors to be MD [odds ratio (OR): 2.549; 95% confidence interval (CI): 1.519-4.275] (P<0.001); `precontemplation` stage of change (OR: 7.798; 95% CI: 2.442-24.898) (P<0.001); previous coronary bypass graft surgery (OR: 4.062; 95% CI: 1.356-12.169) (P=0.012); and previous anxiolytic use (OR: 2.365; 95% CI: 1.095-5.107) (P=0.028). Negative predictors were diagnosis of MI (OR: 0.575; 95% CI: 0.361-0.916) (P=0.019); duration of hospitalization (OR: 0.935; 95% CI: 0.898-0.973) (P=0.001); smoking onset age (OR: 0.952; 95% CI: 0.910-0.994) (P=0.028); number of attempts to quit smoking (OR: 0.808; 95% CI: 0.678-0.964) (P=0.018); and `action` stage of change (OR: 0.065; 95% CI: 0.008-0.532) (P= 0.010). Conclusion Depression, no motivation, shorter hospitalization, and severity of illness contributed to postdischarge resumption of smoking by patients with acute coronary syndrome, who underwent hospital-initiated smoking cessation.

Prediction of psychological adjustment to multiple sclerosis

This study examined the utility of self-efficacy as a predictor of social activity and mood control in multiple sclerosis (MS). Seventy-one subjects with MS were recruited from people attending an MS centre or from a mailing list and were examined on two occasions that were two months apart. Clinic patients were more disabled than patients who completed assessments by post, but they were of higher socioeconomic status and were less dysphoric; We attempted to predict self-reported performance of mood control and social activity at two months, from self-efficacy or performance on these tasks at pretest. Demographic variables, disorder status, disability, self-esteem and depression were also allowed to compete for entry into multiple regressions. Substantial stability in mood, performance and disability was observed over the two months. In both mood control and social activity, past performance was the strongest predictor of later performance, but self-efficacy also contributed significantly to the prediction. The disability level entered a prediction of social activity; but no other variables predicted either type of performance. A secondary analysis predicting self-esteem at two months also included self-efficacy for social activity, illustrating the contribution of perceived capability to later assessments of self-worth. The study provided support for self-efficacy as a predictor of later behavioural outcomes and self-esteem in multiple sclerosis. (C) 1997 Elsevier Science Ltd.

How can and do Australian doctors promote physical activity?

Background. Physical inactivity is recognized as an important public health issue. Yet little is known about doctors' knowledge, attitude, skills, and resources specifically relating to the promotion of physical activity. Our survey assessed the current practice, perceived desirable practice, confidence, and barriers related to the promotion of physical activity in family practice, Methods. A questionnaire was developed and distributed to all 1,228 family practitioners in Perth, Western Australia. Results. We received a 71% response (n = 789). Family practitioners are most likely to recommend walking to sedentary adults to improve fitness and they are aware of the major barriers to patients participating in physical activity. Doctors are less confident at providing specific advice on exercise and may require further skills, knowledge, and experience, Although they promote exercise to patients through verbal advice in the consultation, few use written materials or referral systems, Conclusions. There are significant differences between self-reports of current practice and perceived desirable practice in the promotion of physical activity by doctors, Future strategies need to address the self-efficacy of family physicians and involve resources of proven effectiveness. The potential of referral systems for supporting efforts to increase physical activity by Australians should be explored. (C) 1997 Academic Press.

Clinical supervision in four mental health professions: A review of the evidence

This paper examines a range of theoretical issues and the empirical evidence relating to clinical supervision in four mental health professions, namely clinical psychology, occupational therapy, social work, and speech pathology. Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in this area. It is not clear whether supervision actually produces a change in clinician behaviour, nor whether it produces benefits in terms of client outcomes. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, to date, we have little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, the paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

Improving pain management by nurses: A pilot peer intervention program

Significant pain continues to be reported by many hospitalized patients despite the numerous and varied educational programs developed and implemented to improve pain management. A theoretically based Peer Intervention Program was designed from a predictive model to address nurses' beliefs, attitudes, subjective norms, self-efficacy, perceived control and intentions in the management of pain with p.r.n. (as required) narcotic analgesia. The pilot study of this program utilized a quasi-experimental pre-post test design with a patient intervention, nurse and patient intervention and control conditions consisting of 24, 18 and 19 nurses, respectively. One week after the intervention, significant differences were found between the nurse and patient condition and the two other conditions in beliefs, self-efficacy, perceived control, positive trend in attitudes, subjective norms and intentions. The most positive aspects of the program were supportive interactive discussions with peers and an awareness and understanding of beliefs and attitudes and their roles in behavior.

The Alcohol Helplessness Scale and its prediction of depression among problem drinkers

Event-specific scales commonly have greater power than generalized scales in prediction of specific disorders and in testing mediator models for predicting such disorders. Therefore, in a preliminary study, a 6-item Alcohol Helplessness Scale was constructed and found to be reliable for a sample of 98 problem drinkers. Hierarchical multiple regression and its derivative path analysis were used to test whether helplessness and self-efficacy moderate or mediate the link between alcohol dependence and depression, A test of a moderation model was not supported, whereas a test of a mediation model was supported. Helplessness and self-efficacy both significantly and independently mediated between alcohol dependence and depression. Nevertheless, a significant direct effect of alcohol dependence on depression also remained, (C) 2001 John Wiley & Sons, Inc.