Biomedical subjects

L S Aiken

Publications and source records attributed to L S Aiken.

At least 19 recordsLinked to original sources

PubMed2001

Predicting expressed emotion: a study with families of obsessive-compulsive and agoraphobic outpatients.

The authors used structural equation modeling to examine expressed emotion (EE) in relatives of outpatients with panic disorder with agoraphobia (n = 42) or obsessive-compulsive disorder (n = 60). EE was examined as a function of patients' illness and personality and as a function of characteristics of relatives themselves. EE was operationalized in terms of hostility on the Camberwell Family Interview (C. E. Vaughn & J. P. Leff, 1976) and patients' ratings of their relatives' criticism (perceived criticism). Key findings include the identification of a characteristic of the relative (self-reported angry thoughts, feelings, and behaviors) that is directly linked to both hostility toward the patient and to perceived criticism, as well as a direct path between relatives' low rates of observed problem solving and their hostility toward the patient. Patient Pathology predicted perceived criticism but not observer-rated hostility.

Adolescent↗

PubMed2000

Family conflict and children's internalizing and externalizing behavior: protective factors.

The current investigation examined whether the positive association of family conflict to adolescent depression and conduct problems is attenuated by maternal, paternal, and peer attachment, and maternal and paternal monitoring, within a low-income, multiethnic sample of 284 adolescents. Parental attachment and monitoring moderated the link from family conflict to conduct problems but not depression; the relationships among family conflict, the hypothesized protective factors, and conduct problems were further modified by adolescent gender but not ethnicity. In general, higher levels of the hypothesized protective factors attenuated the relationship between family conflict and conduct problems for girls but exacerbated this relationship for boys. These findings suggest that, in general, parental attachment and monitoring served as protective factors for girls while serving as additional risk factors for boys in conflictual families.

Adolescent↗

PubMed2000

A psychosocial model of sun protection and sunbathing in young women: the impact of health beliefs, attitudes, norms, and self-efficacy for sun protection.

A psychosocial model of sun protection and sunbathing as distinct behaviors was developed on 202 young Caucasian women and replicated in an independent sample (n = 207). Proximal outcomes were intention to sun protect and intention to sunbathe; distal outcomes included sun protection and sunbathing behavior measured 5 months later. Objective risk for skin cancer plus 4 classes of psychosocial variables (sun-protective health beliefs, self-efficacy for sun protection, attitudes toward sunbathing, and norms for sunbathing and sun protection) served as predictors. Sun-protective norms and self-efficacy for sun protection predicted only intention to sun protect; sunbathing norms predicted only intention to sunbathe. Susceptibility and advantages of tanning predicted both intention constructs, which, in turn, predicted behavior. These findings distinguish sun protection from sunbathing and provide a basis for intervention design.

Adolescent↗

PubMed1998

Mammography screening for women under 50: women's response to medical controversy and changing practice guidelines.

The controversy concerning the efficacy of mammography screening for reducing breast cancer mortality among women aged 40 to 49 has continued throughout much of this decade. We examined the impact of this controversy on a community sample of women aged 40 to 60 in 2 data collections (n = 146 and n = 51, respectively), each time following a critical point in the controversy. At initial data collection, only 19% of women identified the specific nature of the debate. Women reported that physicians did not recommend waiting to age 50 to be screened. The women supported screening in the 40s. Those in their 40s intended to continue screening. At 2nd data collection, women showed awareness of inaccuracies in mammography screening, but intended to continue screening nonetheless. These results suggest that health care consumers will not easily relinquish medical innovations that previously have been integrated into usual health care.

Adult↗

PubMed1997

Young women's condom use: the influence of acceptance of sexuality, control over the sexual encounter, and perceived susceptibility to common STDs.

A comprehensive model of the determinants of condom use among young women was developed, tested, and replicated, with longitudinal follow-up to assess predictive utility of the model for condom use over time. Participants in Study 1 and Study 2 were 198 female undergraduates (mean age, 18.6 years) and 238 female undergraduates (mean age, 19.1 years), respectively. Acceptance of sexuality and control over the sexual encounter were related to a multidimensional measure of condom use self-efficacy, which predicted condom use intentions. Perceived susceptibility to STDs was both directly related to intentions and indirectly related through perceived benefits and attitudes about condom use. Intentions predicted subsequent reports of condom use. The model suggests foci for condom use interventions for young women.

Adolescent↗

PubMed1996

Increasing condom use: evaluation of a theory-based intervention to prevent sexually transmitted diseases in young women.

A multicomponent intervention to increase condom use in sexually active young women was designed, implemented, and evaluated in a randomized experiment. Participants were 198 unmarried female college students (mean age = 18.6 years) who received a 1-session condom promotion intervention or a control (stress management) intervention. The condom promotion intervention led to increased self-reported condom use up to 6 months following intervention as well as positive changes in perceived benefits of condom use, affective attitudes toward condom use and condom users, perceived acceptance of sexuality, control over the sexual encounter, perceived self-efficacy for condom use, and intentions to use condoms. Mediational analysis illustrated the mechanisms of the condom promotion intervention effects, linking psychological constructs affected by the intervention (perceived benefits, acceptance of sexuality, control over the sexual encounter, attitudes toward condoms, and self-efficacy for condom use) to condom use intentions.

Adolescent↗

PubMed1996

Experimental personality designs: analyzing categorical by continuous variable interactions.

Theories hypothesizing interactions between a categorical and one or more continuous variables are common in personality research. Traditionally, such hypotheses have been tested using nonoptimal adaptations of analysis of variance (ANOVA). This article describes an alternative multiple regression-based approach that has greater power and protects against spurious conclusions concerning the impact of individual predictors on the outcome in the presence of interactions. We discuss the structuring of the regression equation, the selection of a coding system for the categorical variable, and the importance of centering the continuous variable. We present in detail the interpretation of the effects of both individual predictors and their interactions as a function of the coding system selected for the categorical variable. We illustrate two- and three-dimensional graphical displays of the results and present methods for conducting post hoc tests following a significant interaction. The application of multiple regression techniques is illustrated through the analysis of two data sets. We show how multiple regression can produce all of the information provided by traditional but less optimal ANOVA procedures.

Adaptation, Psychological↗

PubMed1996

Mammography benefits for women under 50: a closer look at the controversy.

The debate concerning the effectiveness of mammography screening for reducing breast cancer mortality rates among women in their 40s is explored. The most recent data from randomized clinical trials (RCTs) are presented. Lack of adequate statistical power in these trials is addressed. Temporal factors in young women's breast cancer (sojourn and survival times) that potentially affect RCT outcomes are explored. Current and planned activities at the national and international levels aimed to further examine the highly controversial issue of mass screening of younger women are described.

Adult↗

PubMed1995

Perceived determinants of risk for breast cancer and the relations among objective risk, perceived risk, and screening behavior over time.

Interrelations among perceived risk for breast cancer, objective risk factors, and both breast self-examination (BSE) and mammography screening were examined across two waves of a longitudinal study of breast cancer screening. Participants were a community sample of 335 predominantly White middle-class women, aged 37 to 77, who had not had breast cancer. Factors believed by women to determine their self-rated risk level for breast cancer were investigated. Women held optimistic biases about their own breast cancer risk; they often erroneously attributed their relatively lower perceived risk to personal actions, including mammography screening. Compliance with mammography screening but not BSE recommendations increased over time. Perceived susceptibility to breast cancer was related to both family history and breast symptomatology; early mammography screening was positively related to perceived susceptibility later in time.

Adult↗

PubMed1994

Structural equation analyses of clinical subpopulation differences and comparative treatment outcomes: characterizing the daily lives of drug addicts.

The use of structural equation modeling (SEM) is illustrated for comparative treatment outcome research conducted with heterogeneous clinical subpopulations within large multimodality treatment settings. All analyses are accomplished with SEM analogs of more familiar classical multivariate techniques. The effect of the early period of treatment on the daily lives of 486 clients in two drug abuse treatment modalities (methadone maintenance and outpatient counseling) is evaluated. Structured means analysis is used to assess initial differences between modalities on the latent means of 6 latent constructs reflecting daily life. The effect of treatment modality and attrition from the program on daily life latent constructs is evaluated while initial selection differences are statistically controlled. Effect sizes are computed on the basis of SEM parameter estimates. The advantage of SEM over classic multivariate approaches for correcting for selection bias when assessing comparative outcomes is explained.

Activities of Daily Living↗

PubMed1994

Health beliefs and compliance with mammography-screening recommendations in asymptomatic women.

The utility of the health belief model (HBM) for predicting compliance with the American Cancer Society recommendations for mammography screening over and above demographics, knowledge, physician input, and objective risk for breast cancer was assessed. In all, 615 predominantly middle-class White women, age 35-92, were surveyed in 1987-1989. A multiple indicator measurement model of the HBM constructs of perceived susceptibility, severity, benefits, and barriers was verified with confirmatory factor analysis. Physician input alone accounted for 25% of the variance in compliance; HBM constructs alone, 16%. HBM constructs accounted for 7% additional variance in compliance beyond all other predictors and thus may be a fruitful focus for interventions to increase screening rates.

Adult↗

PubMed1994

Increasing screening mammography in asymptomatic women: evaluation of a second-generation, theory-based program.

Two theory-based programs to increase mammography screening rates among asymptomatic women were implemented and evaluated in the community. One program (E) was based on the Health Belief Model (HBM); the second program (EP) added exercises adapted from the social psychology of compliance. Program impact on screening among 295 primarily Caucasian, middle-class women was evaluated against untreated controls (C) over a 6-month period. Both programs led to increases in HBM components (Perceived Susceptibility, and Perceived Benefits) and Intentions to obtain a mammogram. Screening rates 2 to 3 times higher were observed in the EP and E over C conditions; EP and E did not differ. A mediational model of compliance illustrated the interplay of HBM components in the compliance process.

Adult↗

PubMed1993

Probing the effects of individual components in multiple component prevention programs.

Assessing the contributions of individual components in multi-component interventions poses complex challenges for prevention researchers. We review the strengths and weaknesses of designs and analyses that may be useful in answering three questions: (1) Is each of the individual components contributing to the outcome? (2) Is the program optimal? and (3), Through what processes are the components of the program achieving their effects? Factorial and fractional factorial designs in which a systematically selected portion of all possible treatment combinations is implemented are used to address question 1. Response surface designs in which each component is quantitatively scaled are explored in relation to question 2. Mediational analysis, a hybrid of experimental and correlational approaches, is considered in relation to question 3. Design enhancements are offered that may further strengthen some of these techniques. These techniques offer promise of enhancing both the basic science and applied science contributions of prevention research.

Combined Modality Therapy↗

PubMed1993

Life activities and life quality of heroin addicts in and out of methadone treatment.

The focus of the present study was the daily life activities and self-perceived health and life quality of heroin addicts both in and out of methadone treatment, based on 219 addicts followed for 8 months after treatment entry. The majority of outcome evaluations of methadone treatment have focused on the "hard" outcome criteria of drug use levels, criminal activities, and employment. The present study, in contrast, addressed how heroin addicts live on a daily basis, and whether being chemically supported on methadone was associated with changes in daily life activities and perceived quality of life. A six-dimensional measurement model of daily life activities, perceived health, and life quality was established. Substantial changes on the dimensions in a positive direction were found in the 2 months just following treatment entry. Changes in daily life activities (e.g., spending more time with the family, attending to the home) may be early indicators of the impact of methadone treatment that precede changes on the usual "hard" criteria (e.g., obtaining legal employment).

Activities of Daily Living↗

PubMed1992

The health belief model and adolescents with insulin-dependent diabetes mellitus.

We tested the predictive utility of the health belief model (HBM) for adherence with a complex, ongoing medical regimen in the context of a chronically ill youthful population (56 adolescent outpatients with insulin-dependent diabetes mellitus; mean age = 14 years). A three-construct model of health beliefs was tested: Threat (perceived susceptibility combined with severity), Benefits-Costs, and Cues to seek treatment. Multiple indicators of compliance were used, and metabolic control was measured by glycosylated hemoglobin. The Benefits-Costs and Cues constructs were related to compliance in the theoretically expected positive direction. Threat interacted with Benefits-Costs in the prediction of compliance and with Cues in the prediction of metabolic control. The greatest compliance was achieved with low perceived Threat and high perceived Benefits-Costs. Poor metabolic control was associated with high Threat and Cues. As age increased, adherence to the exercise, injection, and frequency components of the regimen decreased.

Adaptation, Psychological↗

PubMed1990

Increasing the use of mammography: a pilot program.

Despite the effectiveness of mammography, a large percentage of eligible women do not obtain screening mammograms. Two programs designed to increase the use of mammography were designed, implemented and evaluated. One hundred and fifty-six women were recruited and assigned to an Educational plus Psychological program (EP), an Educational program (E), or to a delayed treatment control group (C). Women completed a pretest, a posttest (EP and E only) and a telephone follow-up. At posttest, EP women had greater intention to obtain a mammogram than C women. EP and E women had higher levels of knowledge and higher levels of perceived benefit of mammography than C women. Actual compliance did not differ among the three conditions. Implications for the design of future programs are discussed.

Adult↗

PubMed1986

Retrospective self-reports by clients differ from original reports: implications for the evaluation of drug treatment programs.

In a longitudinal study, 344 drug addicts in treatment described their status at three points in time: at treatment intake, and at 2 months and 8 months after intake. At the final interview they retrospectively described their prior status at treatment entry and 2 months after treatment entry. The retrospective reports were systematically more negative than the original reports in such areas as illicit behavior, sources of income, and life satisfaction. The results were interpreted in terms of an impression management explanation which suggests that clients distort their early self-presentations to access desired treatment services. A consequence of having artificially elevated pretreatment measures is that even if treatment is beneficial, elevated pretreatment measures may obscure true gains during treatment.

Adult↗

PubMed1985

Ex-addict versus nonaddict counselors' knowledge of clients' drug use.

The accuracy of drug counselors' knowledge of their clients' drug use was assessed to determine whether counselor reports might constitute adequate research and evaluation data. Ex-addict paraprofessionals, non-ex-addict paraprofessionals, and degreed professional counselors (N = 82) reported on the drug use by 302 methadone maintenance and drug-free outpatient clients, as did the clients themselves. Counselor nonresponse rates to individual drug category items were acceptably low (less than or equal to 5%) for all but marijuana/hashish and over-the-counter drugs. Counselors' estimates of drug use rates at a group level were relatively accurate. However, reliability coefficients reflecting accuracy on a case-by-case basis were lower than desirable for use in prediction schemes for individual clients. Ex-addicts were overall somewhat more accurate than the other counselor groups.

Allied Health Personnel↗