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PubMed1976

Changing attitudes of medical teachers towards medical education.

If medical education is to improve, this is largely dependent upon the attitudes of clinical teachers towards their own teaching and their students' learning. The aims and objectives of our workshop method of medical teacher training therefore includes some in the affective domain. Based on the theory of cognitive dissonance the experience-linked practical problem solving approach of the workshop encourages behaviour change, presuming this to cause 'attitude change'. Testing by means of a specially constructed and validated Likert-type attitude scale shows that attitudes do improve significantly and consistently over the 5 days of our workshops. A follow-up study shows these effects to be maintained and taken back to the participants' own medical schools.

Attitude of Health Personnel↗
PubMed1991

Psychologic characteristics of men with alopecia androgenetica and their modification.

Psychologic characteristics were studied in a sample of 168 men with alopecia androgenetica who participated in a clinical trial on the efficacy of minoxidil gel. In general, no evidence of psychologic malfunctioning was found. Instead, a slightly more adequate psychologic state was indicated. However, specific problems associated with hair loss were reported by a substantial number of men. Responders with cosmetic improvement in the group over 35 years of age improved more regarding general psychologic maladjustment, inadequacy, and self-evaluation than those who did not respond. A reverse trend was, however, found in the group younger than 35 years of age, where the nonresponders improved more. An explanation for these findings is derived from the theory of cognitive dissonance.

Adolescent↗
PubMedDate not supplied

Culturally induced postpartum depression: a theoretical position.

A three-factor theory, based on an independently conducted survey of 49 primigravidas, is postulated to explain the potential that exists for cultural attitudes toward pregnancy to become precipitating agents in the postpartum depression syndrome. Changes in body proportions, public attitudes, and the social lives of expectant women are viewed primarily as negative experiences which result in a loss of self-esteem. A means of reducing cognitive dissonance by increasing interaction with those also pregnant is proposed.

Adolescent↗
PubMed1997

Psychosocial and pharmacologic explanations of nicotine's "gateway drug" function.

Research has shown that adolescent users of tobacco are much more likely to progress to use of illicit drugs than are nonusers of tobacco. This article suggests potential psychosocial reasons for the progression based on principles of learning theory, Theory of Reasoned Action, Health Belief Model, and Cognitive Dissonance. In addition, a neuropharmacologic causal mechanism is discussed. The existence of tobacco's gateway function has important implications in the nation's efforts to reduce illicit drug use and adolescent smoking.

Adolescent↗
PubMed2003

Tail docking in dogs: can attitude change be achieved?

The debate about tail docking in domestic dogs continues to rage in many developed countries and attitudes expressed by different community groups remain diametrically opposed. Veterinary associations and welfare organisations typically want the practice banned, while many breeders and pure-bred dog associations just as vigorously oppose the introduction of anti-docking legislation. In recent years, much data have been accumulated concerning the welfare implications of tail docking. A recent evaluation of this literature suggests that the practice has little to recommend it and that, in the absence of reasonable case-by-case justification, it may constitute an unacceptable abuse of a sentient species. Given this situation, it is difficult to understand why many canine interest groups, presumably representing those people who care most about the welfare of companion dogs, should continue to hold such strong attitudes in favour of tail docking. In this review we attempt to explain why different community groups might espouse strong but opposing attitudes, despite having access to the same information. We argue that the theory of cognitive dissonance, popular among social psychologists, may provide a useful framework within which to understand, and attempt to alter, attitudes that persist even though they appear contrary to available empirical evidence.

Animal Welfare↗
PubMed1979

The effects of location, experiences with the civil disturbances and religion on death anxiety and manifest anxiety in a sample of Northern Ireland university students.

A total of 315 Northern Ireland university students were compared to 302 Republic of Ireland university students in terms of death anxiety, manifest anxiety, and perception of dangerousness of aspects of their environment and attitudes toward the civil disturbances in Northern Ireland. Also using these variables in the Northern Ireland sample, Protestants were compared to Catholics, those having had experiences with the disturbances were compared to those not having had such experiences, and those living in nominally dangerous areas of Belfast were compared to those living in nominally safer areas of Belfast. Students living in Northern Ireland had higher death anxiety and stronger fears than students living in the Republic. Those having had experiences with the civil violence had higher manifest anxiety and stronger fears than those not having has such experiences. Persons living in safe environments thought the disturbances to be more serious than those living in more dangerous environments, a result which is discussed in terms of the media and cognitive dissonance. Finally, an argument is made that the influence of religious denomination is an overemphasized variable in the understanding of the civil disturbances.

Adult↗
PubMed1999

The effectiveness of psychoanalytic psychotherapy: the role of treatment duration, frequency of sessions, and the therapeutic relationship.

This is an effectiveness study of treatment outcome that relies on patients' perception of their mental health during and after psychoanalytic psychotherapy. Ninety-nine outpatients attending the IPTAR Clinical Center (ICC) responded to the Effectiveness Questionnaire (EQ) adapted from that developed by Consumer Reports. Effectiveness is studied from various perspectives. Findings indicated (1) an incremental gain in effectiveness scores from six to over twenty-four months of therapy; (2) an incremental gain with greater session frequency from one to two or three weekly sessions; (3) facilitation of effectiveness by the experience of a positive relationship with the therapist; (4) an interplay between clinical syndrome and treatment conditions. A method giving clinical validity to the quantitative findings is described. Brief summaries of two recorded interviews reveal differential reconstruction of events that had occurred during treatment. The findings are discussed from the vantage point of two hypotheses: cognitive dissonance and internalization of therapeutic experience.

Adult↗
PubMedDate not supplied

The travesty of choosing after positive prenatal diagnosis.

OBJECTIVE: To integrate the findings of qualitative studies of expectant parents receiving positive prenatal diagnosis. DATA SOURCES: Seventeen published and unpublished reports appearing between 1984 and 2001 and retrieved between December of 2002 and March of 2003. The electronic databases searched include Academic Search Elite, AIDS Information Online (AIDSLINE), Anthropological Index Online, Anthropological Literature, Black Studies, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Digital Dissertations, Dissertation Abstracts Index (DAI), Educational Resource Information Center (ERIC), MEDLINE, PsycInfo, Public Affairs Information Service (PAIS), PubMed, Social Science Abstracts (SocSci Abstracts), Social Science Citation Index, Social Work Abstracts, Sociological Abstracts (Sociofile), Women's Resources International, and Women's Studies. STUDY SELECTION: Qualitative studies involving expectant parents living in the United States of any race, ethnicity, nationality, or class who learned during any time in pregnancy of any fetal impairment by any means of diagnosis were eligible for inclusion. DATA EXTRACTION: Metasummary techniques, including the calculation of frequency effect sizes, were used to aggregate the findings. Metasynthesis techniques, including constant comparison analysis and the reciprocal translation of concepts, were used to interpret the findings. DATA SYNTHESIS: The topical emphasis in the findings is on the termination of pregnancy following positive diagnosis. The thematic emphasis is on the dilemmas of choice and decision making. Positive prenatal diagnosis was for couples an experience of chosen losses and lost choices. Couples managed information to minimize stigmatization and cognitive dissonance. CONCLUSIONS: Existing guidelines for caring for couples after perinatal losses must accommodate the chosen loss experientially defining positive prenatal diagnosis.

Abortion, Induced↗
PubMed1985

Reactions to life-style warnings: coffee and cancer.

A well-publicized report linking coffee to cancer of the pancreas provided an opportunity to examine how people react to life-style warnings. According to the concepts of cognitive dissonance and defensive avoidance, coffee drinkers might be expected to avoid this report or dispute its validity. Within the sample of 89 secretarial and clerical workers, coffee drinkers were found to be somewhat more likely than nondrinkers to be aware of and to recall the contents of the report. The more they drank, the more likely they were to have changed their coffee consumption in response to the new information. Coffee drinking had no effect on interest in receiving a copy of the original report nor were coffee drinkers more likely than nondrinkers to doubt the future confirmation of the reported coffee-cancer link. It was suggested that life-style warnings, particularly warnings about risks that are newly recognized, do not produce strong avoidance motivations. Several reasons for this lack of avoidance are discussed.

Attitude to Health↗
PubMed2006

Aiming at Tobacco Harm Reduction: a survey comparing smokers differing in readiness to quit.

BACKGROUND: Greece has the highest smoking rates (in the 15-nation bloc) in Europe. The purpose of this study was to investigate Greek smokers' intention and appraisal of capability to quit employing the theoretical frameworks of Decisional Balance (DB) and Cognitive Dissonance (CD). METHODS: A cross-sectional study including 401 Greek habitual smokers (205 men and 195 women), falling into four groups according to their intention and self-appraised capability to quit smoking was carried out. Participants completed a questionnaire recording their attitude towards smoking, intention and self appraised capability to quit smoking, socio-demographic information, as well as a DB and a CD scale. RESULTS: The most numerous group of smokers (38%) consisted of those who neither intended nor felt capable to quit and these smokers perceived more benefits of smoking than negatives. DB changed gradually according to smokers' "readiness" to quit: the more ready they felt to quit the less the pros of smoking outnumbered the cons. Regarding relief of CD, smokers who intended but did not feel capable to quit employed more "excuses" compared to those who felt capable. Additionally smokers with a past history of unsuccessful quit attempts employed fewer "excuses" even though they were more frequently found among those who intended but did not feel capable to quit. CONCLUSION: Findings provide support for the DB theory. On the other hand, "excuses" do not appear to be extensively employed to reduce the conflict between smoking and concern for health. There is much heterogeneity regarding smokers' intention and appraised capability to quit, reflecting theoretical and methodological problems with the distinction among stages of change. Harm reduction programs and interventions designed to increase the implementation of smoking cessation should take into account the detrimental effect of past unsuccessful quit attempts.

Journal Article↗
PubMed2001

Patient preference for cancer therapy: an overview of measurement approaches.

PURPOSE: In the era of evidence-based medicine and shared decision making, the formal assessment of patient preference for treatments or treatment outcomes has attracted much attention. In this article, the two most common approaches to the evaluation of preference, ie, utility assessment and probability trade-off assessment, are described. The purpose is to provide clinicians with the background knowledge needed to interpret preference studies published in the literature and to judge whether the reported findings are relevant to their own patients. METHODS: An overview is given of the methods used to assess utilities and probability trade-off scores. Evidence on determinants of such scores is presented. Examples from oncology are provided. Because experience with the treatment plays an important role as a determinant of preferences for both treatments and treatment outcomes, special attention is paid to the interpretation of studies in the light of subject selection. Directions for future research are suggested. CONCLUSION: The choice of approach and the measuring instrument depend on the goal of the preference assessment. Normal psychologic processes, such as coping, adaptation, and cognitive dissonance reduction, cause patients who are about to undergo a therapy or have experienced a therapy to rate it more favorably than other patients do. This should be remembered when using evidence from the literature to inform patients or for patient decision making.

Choice Behavior↗
PubMed1997

The rise and fall of deception in social psychology and personality research, 1921 to 1994.

The frequency of the use of deception in American psychological research was studied by reviewing articles from journals in personality and social psychology from 1921 to 1994. Deception was used rarely during the developmental years of social psychology into the 1930s, then grew gradually and irregularly until the 1950s. Between the 1950s and 1970s the use of deception increased significantly. This increase is attributed to changes in experimental methods, the popularity of realistic impact experiments, and the influence of cognitive dissonance theory. Since 1980 there appears to have been a decrease in the use of deception as compared to previous decades which is related to changes in theory, methods, ethical standards, and federal regulation of research.

Attitude↗
PubMed1997

Connectionism, parallel constraint satisfaction processes, and gestalt principles: (re) introducing cognitive dynamics to social psychology.

We argue that recent work in connectionist modeling, in particular the parallel constraint satisfaction processes that are central to many of these models, has great importance for understanding issues of both historical and current concern for social psychologists. We first provide a brief description of connectionist modeling, with particular emphasis on parallel constraint satisfaction processes. Second, we examine the tremendous similarities between parallel constraint satisfaction processes and the Gestalt principles that were the foundation for much of modem social psychology. We propose that parallel constraint satisfaction processes provide a computational implementation of the principles of Gestalt psychology that were central to the work of such seminal social psychologists as Asch, Festinger, Heider, and Lewin. Third, we then describe how parallel constraint satisfaction processes have been applied to three areas that were key to the beginnings of modern social psychology and remain central today: impression formation and causal reasoning, cognitive consistency (balance and cognitive dissonance), and goal-directed behavior. We conclude by discussing implications of parallel constraint satisfaction principles for a number of broader issues in social psychology, such as the dynamics of social thought and the integration of social information within the narrow time frame of social interaction.

Journal Article↗
PubMed1996

Understanding the influence of gender role identity on the assumption of family caregiving roles by men.

Previous explanations of limited participation by males as family caregivers assume that socialization to dominant gender stereotypes is a universal barrier among men. Overlooked are 1) variations in the degree of internalization of gender typed attitudes that enable intense participation in a wide variety of personal care tasks and the assumption of the chief caregiver role among some men, and 2) social psychological processes used to resolve cognitive dissonance among men considering caregiver activities and/or role enactment. The present examination of these processes is responsive to calls for enhancing our understanding of the personal meaning that caregiving has for men. The introduction of Risman's view that current experience influences socialized predispositions, allows the delineation of conditions under which husbands, sons, and other male relatives who have internalized stereotypical self images of masculinity can also assume caregiver roles in the family. Drawing on interview data from a purposive sample of thirty-two men who were chief caregivers for elderly relatives, case study material is presented to illustrate several pathways by which male respondents gained access to family caregiving roles.

Adult↗
PubMed2001

Effect of response effort on the reward value of distinctively flavored food pellets.

This study was designed to test whether distinctively flavored food pellets, used as rewards for lever-pressing by rats, would acquire different reward values as a function of the differential effort involved in making the lever pressing response which would be predictable from the concept of cognitive dissonance. Subjects were seven Long-Evans strain hooded rats, 301-308 days old at the start of the study and had had their body weights reduced to 80%, of their free-feeding weights. Testing was done in a Y-maze, with food pellets associated with the difficult lever-press response serving as the reward for one choice and pellets associated with the easy lever-press response for the other. Analysis showed there was no preference in the choice of either the "easy" or the "difficult" pellets, the choice not being significantly different from chance. This indicated that the effort involved in making a response did not affect the reward strength of food pellets when used to reward a response with a different topography.

Animals↗
PubMed1989

Recognizing and adjusting to barriers in doctor-patient communication.

Barriers frequently develop in physician-patient encounters. If they go unrecognized, they can severely limit the therapeutic potential of the doctor-patient relationship. Because barriers are not always explicit, a strategy is presented for recognizing implicit signs such as verbal-nonverbal mismatch, cognitive dissonance, unexpected resistance, and physician discomfort. Once a potential barrier is identified, its source can be defined and explored using standard clinical reasoning techniques such as hypothesis generation and testing. Patients can often share in the process of generating hypotheses about the nature and sources of barriers. Once defined and understood, most barriers can be lessened and sometimes resolved using the basic communication skills of acknowledgment, exploration, empathy, and legitimation. When conflict exists, common interests and differences must be clarified. Conflict might involve disagreement about the presence of a barrier, its nature or source, its relevance to the physician-patient relationship, or about strategies for approaching it. Negotiation need not be limited to the initial positions, but can include creative solutions whereby both parties gain. The decision to confront a barrier depends on both doctor and patient readiness, as well as how critical the barrier is to the therapeutic process, and how amenable it is to change. By effectively uncovering and addressing barriers, the physician can often turn roadblocks to effective communication into means for enhancing the therapeutic relationship.

Communication↗
PubMed1999

Depression, psychosis, and dementia: impact on the family.

Similar to the setting of other chronic, debilitating diseases, considerable psychoeducational support of the patient's family and other caregivers represents an often-overlooked component of appropriately thorough care. Nearly three of four persons caring for an individual with PD report psychological stress and anxiety, which are exacerbated by concerns about progression of the disease. Counseling for PD caregivers can be dispensed particularly effectively through individual psychological counseling as well as PD support and community self-help groups that assist caregivers in sharing concerns and promote a sense they are understood by others. Through such measures, which may be delivered effectively by nurse practitioners, PD caregivers can develop effective coping strategies for disease related stressors. Empirical results show the most common stressors are: anxiety, concern about the future, impatience or intolerance, loss of autonomy, sleep disturbances, diminished time and opportunity for recreation and social contact, and anger. These sequelae often ensue when the PD patient evidences depression, advanced dementia, or psychosis, each of which can severely constrain communication. Caregivers often must also contend with two other adverse psychological phenomena: cognitive dissonance surrounding placement of the patient in a nursing home and learned helplessness, which may predispose to depressive states. Other often unmet needs of the "hidden victims" of PD include compromised immune function, social stigmata, and financial difficulties. Respite care may be useful in reducing the stress associated with these and other problems frequently affecting caregivers.

Dementia↗