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Biomedical subjects

L L Harlow

Publications and source records attributed to L L Harlow.

At least 19 recordsLinked to original sources
PubMed2001

Using disease-related and demographic variables to form cancer-distress risk groups.

The use of disease-related (i.e., stage, phase, perceived health) and demographic (i.e., age, education, income) variables to identify subgroups of cancer patients and survivors manifesting divergent risk for psychosocial adjustment problems was assessed. Clustering procedures distinguished three clusters across two subsamples. In each subsample, low-risk participants had a low stage, a later phase, high perceived health, an older age, and a high education and income; moderate-risk participants had a low stage, a later phase, high perceived health, a greater age, and a low education and income; and high-risk individuals had high stage, an earlier phase, low perceived health, an average age, and a low education and income. Mean difference analyses showed that low-risk participants had higher psychosocial adjustment than high- and moderate-risk participants. High-risk participants had lower psychosocial adjustment than moderate-risk participants. The risk for psychosocial adjustment problems may be influenced by disease-related and demographic variables, and implications for the targeting of interventions are discussed.

Adaptation, Psychological↗
PubMed1998

Women HIV sexual risk takers: related behaviors, interpersonal issues, and attitudes.

HIV and AIDS is a growing health risk for heterosexual women, particularly women of color (Centers for Disease Control and Prevention, 1997). Our research identified 5 types of HIV sexual risk taking in 3 independent samples of adult women from a New England Community: Group A women were noted by low to moderate levels of the 4 risk markers (i.e., unprotected vaginal sex, perceived partner-related risk, number of sexual partners, and unprotected anal sex); Group B women reported very high frequency of unprotected vaginal sex; Group C women were characterized by unprotected anal sex; Group D women had high perceived partner risk; and Group E women reported extremely high levels on all 4 HIV risk markers. Sexual risk groups were validated by demonstrating significant differences among groups on relevant behaviors, interpersonal experiences, and attitudes. Compared to other women, higher risk types reported greater behavioral risk practices (substance use, prostitution, diverse sexual experience), interpersonal risk experiences (sexual abuse, violence), initiation sexual assertiveness, and attitudinal risks (psychosocial distress). They reported less interpersonal assurance (surety of own and partner's HIV status), sexual assertiveness (for condom use and partner communication), psychosocial strengths (sexual self-acceptance), and transtheoretical readiness for change (condom use efficacy, readiness to consider condoms). Results provide additional support for the multifaceted model of HIV risk and the transtheoretical model. Suggestions for specifically focused interventions are given, depending on the pattern of sexual risk taking.

Adolescent↗
PubMed1997

Sexual Assertiveness Scale (SAS) for women: development and validation.

Four studies were conducted to develop and validate the Sexual Assertiveness Scale (SAS), a measure of sexual assertiveness in women that consists of factors measuring initiation, refusal, and pregnancy-sexually transmitted disease prevention assertiveness. A total of 1,613 women from both university and community populations were studied. Confirmatory factor analyses demonstrated that the 3 factors remained stable across samples of university and community women. A structural model was tested in 2 samples, indicating that sexual experience, anticipated negative partner response, and self-efficacy are consistent predictors of sexual assertiveness. Sexual assertiveness was found to be somewhat related to relationship satisfaction, power, and length. The community sample was retested after 6 months and 1 year to establish test-retest reliability. The SAS provides a reliable instrument for assessing and understanding women's sexual assertiveness.

Adult↗
PubMed1996

Childhood sexual abuse linked with adult substance use, victimization, and AIDS-risk.

College women who report childhood sexual abuse were compared with women who do not report abuse on a number of variables concerned with problems in living. Multivariate Analysis of Variance revealed that, compared with nonabused women, sexually abused women reported significantly more negative attitudes about sexuality, less sexual assertiveness about birth control or refusing unwanted sex, less efficacy concerning HIV prevention, more anticipation of a negative response from a partner concerning safer sex, more hard-substance use, and more sexual victimization in adulthood. These results support and extend previous work in this area and argue for greater attention to relational issues for interventions with sexually abused women. Limitations to the study and future directions for research are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Substance use clusters in a college sample: a multitheoretical approach.

Substance use factors were examined and cross-validated in a cluster analytic approach in two independent samples of college students: N = 291 and N = 602. Reported frequency, intensity, and amount of substance use were examined for beer, hard liquor, marijuana, amphetamines, barbiturates, psychedelics, cocaine, and heroin. Variables were reduced using Principal Components Analysis (PCA) to form four substance use composites. Composite scores were entered into two different methods of cluster analysis that each identified four distinct clusters of substance use groups. External validity was obtained by showing that these four groups differed on a set of relevant variables. The four groups served as levels of the independent variable, substance use type, in four MANOVAs examining group differences on peer and family influence, psychosocial functioning, habit acquisition, and self-efficacy. Findings indicate that as frequency and intensity of substance use increased, individuals reported more problems in living, although a causal direction cannot be established. The findings are of potential value in early identification, prevention, and education regarding substance use among college populations.

Adaptation, Psychological↗
PubMed1994

Stages of change and decisional balance for 12 problem behaviors.

This integrative study investigated the generalization of the transtheoretical model across 12 problem behaviors. The cross-sectional comparisons involved relationships between two key constructs of the model, the stages of change and decisional balance. The behaviors studied were smoking cessation, quitting cocaine, weight control, high-fat diets, adolescent delinquent behaviors, safer sex, condom use, sunscreen use, radon gas exposure, exercise acquisition, mammography screening, and physicians' preventive practices with smokers. Clear commonalities were observed across the 12 areas, including both the internal structure of the measures and the pattern of changes in decisional balance across stages.

Adult↗
PubMed1994

The transtheoretical model of change and HIV prevention: a review.

The transtheoretical model of health behavior change is described and supporting empirical work is presented that reviews the central constructs of the model: the stages of change, processes of change, decisional balance, confidence, and temptation. Model-based applications to a broad range of problem behaviors are summarized. Applications to human immunodeficiency virus (HIV) prevention behavior changes are highlighted for each variable. Finally, several questions about the area of sexual behavior change to reduce risk of HIV exposure are explored and future research ideas are described within the context of this model.

Attitude to Health↗
PubMed1993

Self-perception variables that mediate AIDS-preventive behavior in college students.

Three psychological variables--self-efficacy, control and meaning, and perceived risk--were tested in a structural model predicting AIDS-preventive behavior. Results revealed a good model fit, indicating that these psychological variables did play a role in mediating AIDS-preventive behavior in college students. A multivariate analysis of variance and individual analyses of variance conducted for men and women also revealed gender differences on individual items of self-efficacy, perceived risk, and AIDS-preventive behavior. This study underscores the importance of identifying and assessing the psychological determinants of AIDS-preventive behavior.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Path analysis of a self-esteem model across a competitive swim season.

An adaptation of the previously developed Exercise and Self-Esteem Model (Sonstroem & Morgan, 1989) was tested longitudinally with 93 male interscholastic swimmers from nine high schools who were evaluated at pre-, mid-, and postseason. Swimmers completed three self-perception scales that ranged from evaluations of specific swim skills (SKILL) through broader perceived physical competence (PC) to global self-esteem (SE). Performance scores (PERF) were calculated across events by standardizing swim times to a mean of 0 and a standard deviation of 1. Structural modeling analysis across the three time waves indicated an excellent data fit (chi 2 = 25.46, p > .15). The model was able to explain 84, 83, and 80% of PC, SKILL, and PERF, respectively, at the third testing period. Swim improvement tended to be small (median change = 2.9%). Relationships among variables at each testing period and among the same variables at different testing periods were large and as hypothesized. Several significant relationships occurred between different variables across different testing periods. These were not extinguished when social desirability was added to the model. Social desirability failed to significantly influence subsequent measures of any model variable.

Adolescent↗
PubMed1991

Test of structural relationships within a proposed exercise and self-esteem model.

This study tested structural relationships within a model proposed to explain the manner in which self-esteem changes are associated with exercise experiences. As initially assessed by self-efficacies (EFFs) specific to physical tasks within a training program, we postulated that competence can generalize to feelings of global self-esteem (SE) through an intervening construct of perceived physical competence (PC). Three measures of EFF and two each of PC and SE were administered to 145 people in their mid- to late adulthood. Confirmatory factor analysis examined orthogonal and oblique versions of three measurement models and identified three distinct but correlated factors, each assessed by its hypothesized indicators. Alternative structural equation models were specified and tested using both normal and nonnormal estimation procedures. The proposed model provided the most parsimonious fit and explained 29% of the variance in SE. Confirmation of its structural relationships provides preliminary validity for model use in examining the manner in which exercise experiences influence levels of self-perception.

Journal Article↗
PubMed1987

Purpose in Life Test assessment using latent variable methods.

A psychometric assessment was conducted on a slightly revised version of the Purpose in Life Test (PIL-R). Factor analyses revealed a large general factor plus four primary factors comprising lack of purpose in life, positive sense of purpose, motivation for meaning, and existential confusion. Validity models showed that the PIL-R was positively related to a construct of happiness and was negatively related to suicidality and meaninglessness. Reliability estimates ranged from 0.78 to 0.86. The revised version can be presented compactly and may be less confusing to subjects than the original PIL.

Adult↗
PubMed1987

Similarity of behavior within addict couples. Part II. Addiction-related variables.

The similarity of behavioral patterns within addict couples before, during, and after a relationship is the focus of this paper. The correlations between partners in real and artificially constructed (pseudo) couples for employment, criminal activities, and other behaviors are examined. The effect of a relationship on behavior is also assessed before, during, and after treatment. Significant correlations during real relationships were found for employment, welfare, and illegal income. Joint couple entry into treatment appears to be more effective for women than men. Similarity within couples disappears when the relationship ends.

Behavior↗
PubMed1987

Similarity of behavior within addict couples. Part I. Methodology and narcotics patterns.

The development and initial assessment of a methodology for measuring the similarity of behavioral patterns within addicted couples over the duration of a relationship is presented. Two subsamples of addicts from methadone maintenance programs in southern California were established: one of couples who had a real relationship during their addiction and treatment careers, and a group of pseudocouples (matched as closely as possible) created from unrelated clients in the same programs. Narcotics use, abstinence, and support patterns are analyzed for couples before, during, and after their relationship. When it occurs during the relationship, treatment effects are also analyzed.

Adult↗
PubMed1986

Depression, self-derogation, substance use, and suicide ideation: lack of purpose in life as a mediational factor.

A theoretical model of adolescent behavior is examined separately for males and females (N = 722). The model hypothesizes that depression and self-derogation may lead to a lack of purpose in life, which, in turn, may lead to suicide ideation and substance use. Confirmatory factor analyses and structural equation procedures were used to examine the model, using Bentler's (1984) EQS computer program, which is available from BMDP. For both the men and women, the model adequately accounted for the data although there were some important differences between the sexes. In response to psychic discomfort (i.e., Depression and Self-derogation), men are more apt to turn to drugs and alcohol, whereas women consider suicide. Conversely, the situation changes in response to feelings of meaninglessness or a lack of purpose in life. Here, the females appear to turn to substance use, whereas the males react with thoughts of suicide.

Adult↗
PubMed1986

Life events and substance use among adolescents: mediating effects of perceived loss of control and meaninglessness in life.

Throughout history, alcohol and other drugs have been used to provide relief in times of stress and frustration. Research has confirmed this association between disruptive life change events and substance use. It was hypothesized that two psychological constructs facilitate and mediate this relation between stress and substance use. Uncontrollable stress (negative life change events) was assumed to create a sense of loss of control, which in turn engendered a decreased level of meaning in life. This meaninglessness in life, experienced as distressful and uncomfortable, is then treated or medicated with various drug substances. This theoretical sequential model was tested in two separate studies with independent samples of adolescents (one sample collected by the Rutgers University and the other collected by the University of California, Los Angeles [UCLA]) using latent variable structural models. The Rutgers sample was cross-sectional, whereas the UCLA sample provided longitudinal data. Results supported the theoretical hypothesis that Perceived Loss of Control and Meaninglessness mediate the relation between Uncontrollable Stress and Substance Use. In the Rutgers data, the association between stress and drug use was clearly accounted for by the mediating constructs; in other words, no direct path was necessary to explain the relation between stress and general drug use. However, in the UCLA data there remained a direct influence of Uncontrollable Stress on Substance Use after accounting for the significant impact of the mediating constructs. Five other competing models were tested; four were rejected empirically, and the other was accepted, although it was less theoretically based than the mediational model.

Adolescent↗
PubMedDate not supplied

A structural model of the relationships among stage of disease, age, coping, and psychological adjustment in women with breast cancer.

The present study used structural equation modeling to examine the relationships among disease stage (i.e. Stage II versus Stage IV), age, coping style, and psychological adjustment in 100 women diagnosed with breast cancer. Five separate models were examined: a full model, a mediational model, a demographic-disease model, a coping style model, and a regression model The analyses revealed that the present data best fit the mediational model in which age and stage of disease were not directly associated with psychological adjustment but, instead, were mediated by coping style (chi 2(25) = 45.776, AASR = 0.05, CFI = 0.94). The mediational model accounted for 56% of the variance in psychological adjustment. In particular, the model showed that younger women and women with an earlier disease stage used greater levels of the coping strategy characterized as a fighting spirit and lower levels of the coping strategies characterized as hopelessness/helplessness, anxious preoccupation, and fatalism which, in turn, were related to better psychological adjustment. Overall, these findings may offer an explanation for the conflicting findings regarding the relationship between age, stage of disease, and psychological adjustment to breast cancer by illustrating that coping strategies may be an essential mediating factor; in turn, a mediating model of psychological adaptation may offer useful information for clinicians as they implement interventions designed to improve patients coping efforts.

Adaptation, Psychological↗
PubMedDate not supplied

Using two factor structures of the Mental Adjustment to Cancer (MAC) scale for assessing adaptation to breast cancer.

The validity and reliability of two factor structures of the Mental Adjustment to Cancer (MAC) scale for assessing coping style was assessed by examining the relationship between the subscales, psychological distress, and quality of life (QOL) among Stage II and Stage IV breast cancer patients in four phases. First, MANOVAs assessed differences in coping, distress, and QOL across disease stages. Second, for each MAC factor structure, canonical correlation analyses assessed the relationship between coping styles, distress, and QOL, for each disease-stage group separately. Third, structural equation modeling (SEM) assessed the relationship among coping styles, distress, and QOL for all participants. Finally, the internal consistency of both MAC factor structures was assessed using Chronbach's alpha. The results were as follows: (1) significant differences across disease stages were found for coping styles using either the Watson or the Schwartz MAC subscales, but there were no differences in levels of distress or QOL; (2) for both MAC factor structures, coping style was found to be highly related to emotional distress and QOL, however, the strengths of the correlations between individual coping styles and distress/QOL indicators varied across disease stages; (3) SEM indicated that coping style was significantly related to distress and QOL when stage of disease was not considered, and that coping style and indicators of distress/QOL are separate, but highly correlated factors, as opposed to a single latent construct; and, (4) the Watson MAC subscales showed slightly better internal consistency than the Schwartz MAC subscales. Taken together, these findings highlight: (i) the validity of both MAC factor structures for clinical and research use with American breast cancer patients; (ii) the role of coping style as a mediator between disease stage and psychological distress and QOL; and, (iii) the need for refinement of certain Watson and Schwartz subscales.

Adaptation, Psychological↗