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PubMed1979

Measurement of assertive behavior: construct and predictive validity of self-report, role-playing, and in-vivo measures.

Examined the predictive validity and construct equivalence of the three major procedures used to measure assertive behavior: Self-report, behavioral role-playing, and in-vivo assessment. Seventy-five Ss, who spanned the range of assertiveness, completed two self-report measures of assertiveness, the Rathus Assertiveness Scale (RAS) and the College Self-Expression Scale (CSES); two scales from the Endler S-R Inventory of General Trait Anxiousness, the interpersonal and general anxiety scales; eight role-playing situations that involved the expression of positive and negative assertiveness; and a telephone in-vivo task. In general, the study revealed the following: (1) assertiveness measures are task-dependent in that there was more overlap within task than between tasks; (2) there is a moderate degree of correspondence between self-report and role-playing measures, although this was true only for negative assertion; (3) positive and negative assertion do not appear to have the same topography of responding; and (4) there appears to be no consistent relationship between the in-vivo measure and any other type of assertiveness measure.

Anxiety↗

PubMed2003

[Effects of a sexual assertiveness training program in high school girls].

PURPOSE: This study was done to develop an applicable training program for high school girls on sexual assertiveness. METHOD: The design combined methodological study and non-synchronized quasi experimental study designs. The participants were 174 high school girls from two schools. Two questionnaires were used, one consisted of 23 questions on self efficacy and the other, of 22 items on sexual assertiveness. The SPSS 10.0 program was used for data analysis. Experimental group 1(3 hour program) and experimental group 2(6 hour program) were received on sexual assertiveness. The sexual assertiveness program was carried out by members of the research team. There were no differences in demographic characteristics between control group, experimental group 1, and experimental group 2. RESULT: There was no significant increase in self efficacy scores in experimental group 1 over the control group, but there was a significant increase in sexual assertiveness scores in the experimental group 1 over the control group. There was an increase in self efficacy scores in experimental group 2 over the control group, but it was not significant. There was a significant increase in sexual assertiveness scores in experimental group 2 over the control group. There was no significant increase in self efficacy scores in the experimental group 2 over the experimental group 1, and there was no significant increase in sexual assertiveness scores in experimental group 2 over the experimental group 1. CONCLUSION: The results show that a 3 hour program was as effective as a 6 hour program for sexual assertiveness. Therefore, it is advisable to use a 3 hour program for clinical convenience. But further study is needed to determine the lasting effect on sexual assertiveness.

English Abstract↗

PubMed1983

Race as an interpersonal variable in negative assertion.

Investigated assertive behavior among black male psychiatric patients under white vs. black interpersonal partner conditions. Twenty-four high and 24 low scorers in level of measured general assertiveness served as Ss (N = 48). Responses to familiar and unfamiliar interpersonal stimuli in two conditions, role-play, and in vivo, were videotaped and rated. Dependent variables in the role play condition were: (1) Request for new behavior; (2) compliance; (3) affect; and (4) overall assertiveness; and (1) expression of negative opinion; (2) compliance; and (3) overall assertiveness for the in vivo condition. Although MANOVA revealed no main effect for race, Ss in the unfamiliar condition were more assertive (p less than .05) than those in the familiar role play condition. Also, Ss' responses in role play were more assertive (p less than .05) in the unfamiliar-white prompter condition as compared to Ss' responses in the unfamiliar-black prompter condition. In the in vivo situation for overall assertiveness, responses were rated as more assertive in the white prompter condition. In addition, although Ss were more likely to express negative opinions in the black prompter condition, they were more likely to comply with an unreasonable request in the white prompter condition.

Adult↗

PubMed2006

[Lack of assertiveness in patients with eating disorders].

BACKGROUND: Low self-assertion has been noted as an important feature among patients with eating disorders. AIM: To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. SUBJECTS AND METHODS: An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. RESULTS: Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p <0.001) and showed a lower level of assertiveness on the RAS (p <0.001). Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. CONCLUSIONS: Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.

Adolescent↗

PubMed1986

Four-year results of a youth smoking prevention program using assertiveness training.

Assertiveness training and its relationship to smoking behavior and how young adolescent boys and girls differ with respect to assertion was investigated. A total of 161 seventh-grade students from six health education classes participated. Two classes received an innovative smoking education program, two classes received assertiveness training plus an innovative smoking education program, and two classes received only the smoking education program usually offered by the school. Locus of control and levels of assertion and smoking behavior were assessed at pre- and posttest. The results indicate that boys are significantly more assertive than girls at age 12 (p = .0018), and this assertiveness increases equally over the next four years (p less than .0001). There were no significant differences in smoking behavior among the three groups; however, trends in smoking behavior in the desired direction were observed. There is no significant difference in smoking behavior between boys and girls. In this respect the sexes have reached equality, that is, girls are initiating cigarette smoking as frequently as are boys. Finally, there were no significant changes in assertion among the groups. It is concluded that the utility of assertiveness training for young adolescents is questionable.

Adaptation, Psychological↗

PubMed1980

Assertiveness training with high school students.

Baseline assessments of assertiveness were determined prior to instituting a 10-week assertion training program with 85 ninth-and twelfth-grade adolescents. Initial self-report measures of assertiveness indicated that females experienced significantly more discomfort in assertion situations than males. Baseline measures also revealed that while assertiveness increased with age in males, it decreased over grade levels with females. Data from the baseline assessments were used to structure an intervention program in which subjects were randomly assigned to groups which received assertiveness training twice a week for one hour. Prior to data analysis, each group was classed as either high- or low-cohesive. The results indicated a significant increase in assertiveness in the highly cohesive training groups on a behavioral measure of assertiveness.

Adolescent↗

PubMed1999

Patient assertiveness and physician decision-making among older breast cancer patients.

The objective of this study was to determine whether assertive patient behavior influences physician decision-making in the treatment of older breast cancer patients. One hundred and twenty-eight physicians saw videotapes depicting women seeking care for breast cancer and then recommended evaluation and treatment plans. Identical scripts were used, but the age, race, socioeconomic status, mobility, general health, and assertive behavior of the patients were experimentally varied along with the physician's specialty and length of practice. No direct effects of assertive patient behavior were seen. However, black, comorbid, and lower SES women were more likely to have full staging of their tumors ordered when they made an assertive request. Treatment recommendations also showed an interaction of assertiveness with patient's age and social class as well as physicians' specialty. The results indicate that a moderately assertive patient request may change provider behavior, although the effects of assertiveness vary most by what type of patient demonstrates this behavior. In particular, assertiveness led to more careful diagnostic testing for patients who came from groups that are "disadvantaged."

Aged↗

PubMed2005

A review of the literature considering the role of mental health nurses in assertive outreach.

A review of the literature considering the role of mental health nurses in assertive outreach Assertive outreach teams are a central component of the UK government vision for Mental Health. The general aim of such services is to engage with clients who for one reason or another lose contact with traditional services and require a more flexible approach to care. Researchers and the Government recognize that nurses who work within Assertive Outreach need specialist skills, knowledge and personal attributes to carry out their work. A comprehensive review of the literature was carried out via computer search engines, an Internet search and a hand search of pertinent references. Two screens were applied to the literature to make sure only the highest quality information was evaluated. The results of the literature search were presented in tabular format and three key themes were identified as being important for mental health nurses working in assertive outreach services. These themes were clinical knowledge and skills, successful outcomes for assertive outreach services and personal attributes of practitioners. Multidisciplinary working within assertive outreach services allows for some of the ethical dilemmas to be resolved. However, the competing demands placed on nurses, including risk assessment verses engagement, may lead to high stress levels and burnout. Research studies highlight that without experienced and knowledgeable staff the provision of an assertive outreach model is in jeopardy. The Government and service providers need to ensure that practitioners within assertive outreach services receive sufficient training, managerial and clinical supervision, in order to do the best for a very challenging and chaotic client group.

Community-Institutional Relations↗

PubMed1995

Implementing assertive community treatment teams.

The Connecticut Department of Mental Health began creating assertive community treatment teams in 1987. The authors describe the approach taken by the department in defining the assertive community treatment model, in creating new assertive community treatment teams, and in monitoring the creation and functioning of these teams to ensure that fidelity to the assertive community treatment model is maintained. Assertive community treatment teams can be created even in the absence of funding for new staff by reconfiguring current community-based staff and by moving staff from state hospitals to the community. Preliminary data from a randomized trial in Connecticut comparing assertive community treatment with high-quality case management in areas with an array of community services indicated that the intended models were replicated, with variations in practice style across programs. Clients in assertive community treatment were in the hospital about half as often as clients in standard services and were also less likely to be without a permanent residence. Training and ongoing monitoring of assertive community treatment teams are necessary to detect practices that diverge from the intervention model so that corrective action can be taken.

Adult↗

PubMed1984

California psychological inventory profiles of peer-nominated assertives, unassertives, and aggressives.

Examined the California Psychological Inventory (CPI) profiles of peer-nominated assertives , unassertives , and aggressives . Eighty males from two social fraternities peer-nominated assertives , unassertives and aggressives . The nomination procedure yielded 12 nominees per group. A profile analysis of the CPI indicated that assertives and aggressives were significantly more similar than were assertives and unassertives , and unassertives and aggressives . Results of a subscale analysis indicated that assertives and aggressives were significantly higher on Dominance, Capacity for Status, Sociability, and Social Presence than Unassertives , but were not significantly different from each other on these subscales. Also, assertives were significantly higher on Socialization, Self-Control, and Achievement via Conformance than were aggressives . Finally, assertives were significantly higher on Achievement via Conformance than were unassertives and aggressives . Implications are discussed.

Achievement↗

PubMed2003

Differences in assertive speech acts produced by children with autism, Asperger syndrome, specific language impairment, and normal development.

The assertive speech acts of children with autism (n = 12) and Asperger syndrome (n = 12), individually matched to children with specific language impairment (SLI; n = 24) and children with normal development (n = 24) were studied in the context of gently structured conversation. These children also completed the false belief test of theory of mind. The children with autism used significantly lower proportions of assertions involving explanations and descriptions than the children with SLI or normal development and significantly lower proportions of assertions involving internal state and explanations than the children with Asperger syndrome. The children with autism used a higher proportion of assertions involving identifications than any other group. The assertions of the children with Asperger syndrome were generally not different than those of the children with SLI or normal development except for a higher proportion of assertions involving own internal state. Further analysis of the mental assertions revealed that the children with autism and Asperger syndrome predominantly referred to desire and made few references to thought and belief, whereas the children with SLI and those with normal development used a higher proportion of references to thought and belief.

Asperger Syndrome↗

PubMed2001

Risk taking and refusal assertiveness in a longitudinal model of alcohol use among inner-city adolescents.

Risk taking and refusal assertiveness have been shown to be important determinants of adolescent alcohol use. However, it remains unclear whether youth predisposed to risk taking would be less likely to assertively refuse. This study examined the relationships among risk taking, refusal assertiveness, and alcohol use in a sample of inner-city minority students (N = 1,459), using a cross-lagged longitudinal structural equation model. Data collectors administered the questionnaire to students following a standardized protocol during a 40-min class period. Based on the tested model, risk taking was more stable over time than refusal assertiveness. Furthermore, high risk takers reported less frequent subsequent refusal assertiveness, and less frequent refusal assertiveness predicted greater drinking. A predisposition toward risk taking appears to be an enduring characteristic that is associated with low refusal assertiveness and increased alcohol use. These findings suggest that alcohol prevention programs that emphasize refusal skills training may be less effective for high risk takers. But programs that focus on enhancing competence or reducing normative expectations for peer alcohol use might be more effective for high risk-taking youth.

Adolescent↗

PubMed1982

Changes in assertiveness and changes in orgasmic response occurring with sexual therapy for preorgasmic women.

Assertive behavioral effects of therapy for anorgasmia are examined. Four groups of preorgasmic women were measured on their assertive behavior before, after and four months following therapy focused on obtaining orgasm through self-stimulation. The results of measures of self-reported comfort with assertion as well as probability of acting assertively as measured by the Gambrill-Richey Assertion Inventory indicate that changes did occur in all groups. A significant decrease in felt discomfort with assertive behavior and an increase in the probability of responding assertively was found in all groups. Implications for considering the impact of sexual therapy on various aspects of interpersonal relationships rather than exclusively on symptom removal are suggested.

Adult↗

PubMed2006

[The effect of assertiveness training on communication related factors and personnel turnover rate among hospital nurses].

PURPOSE: The purpose of this study was to investigate the effects of assertiveness training on nurses' assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate. METHOD: A non-equivalent control group pretest-posttest design was used in this study. Nurses were assigned into the experimental or control groups, each consisting of 39 nurses. Data was collected between January to March 2004. An 'Assertiveness Training Program' for Nurses developed by Park was used for the study. To emphasize assertiveness practice, 5 practice sessions utilizing ABCDE principles were added to Park's program. To examine the effects of the program, differences between the two groups in assertive behaviors, interpersonal relations, communication conflicts, conflict management style and personnel turnover rate were analyzed using ANCOVA. RESULTS: The assertiveness training was effective in improving the nurses' assertiveness behaviors, but was not effective in improving interpersonal relations, reducing the subjects' communication conflicts, changing the conflict management style or reducing their personnel turnover rate. CONCLUSION: There have been many studies about factors affecting nurses' personnel turnover rates, but few have been done about methods of intervention to reduce the personnel turnover rate. Thus, this study provides a significant contribution in attempting such an intervention from nursing management perspectives.

Assertiveness↗

PubMed1987

The effects of assertive training on performance in highly anxious adolescents.

The effects of assertive training on measures of assertiveness, state anxiety, and mathematics performance in highly anxious adolescents were investigated. A group of 96 highly anxious 9th graders was assigned to one of four treatment groups. Pretest and posttest assessment included the Adolescent Self-Expression Scale (a measure of assertiveness), the State-Trait Anxiety Inventory, and the Mathematics Problems and Concepts subtests of the California Achievement Test. Experimental treatment consisted of four assertive training sessions, while placebo treatment for the control groups consisted of four career development training sessions. Posttest was administered to all four groups. A MANOVA was used to analyze all of the data on the students who took the pre- and posttest and attended two or more training sessions. Assertive training resulted in increased assertiveness and decreased state anxiety, with no significant effect on mathematics performance, and no significant effect due to sex. It was concluded that assertive training is a counseling technique which can be used effectively with 9th graders.

Achievement↗

PubMedDate not supplied

Nurses in OR are more assertive than radiographers.

This study investigated two hypotheses: that there is a positive correlation between assertiveness and self-esteem, and that nurses rate lower than non-nurses on the constructs. A self-report survey incorporating scales for general assertiveness, situationally-specific assertiveness, global self-esteem and differentiated self-esteem was utilised. For the sample of 83 operating room nurses and 81 radiographers, correlations significant at the p < .001 level between the respective scales supported the first hypothesis. Analysis of variance yielded no significant differences between the two groups on either self-esteem measures or general assertiveness, with the nurses scoring significantly higher than radiographers on the situationally-specific assertiveness scale. Findings challenge the stereotype of the 'shrinking violet' nurse. Additional analysis revealed that the power component of differentiated self-esteem had a higher correlation with global self-esteem and with both assertiveness measures than any other component. Further, the operating room nurses were significantly more power-oriented than radiographers. The pre-eminence of power in the findings suggests that assertiveness and self-esteem are issues relating to the empowerment of nurses.

Allied Health Personnel↗

PubMed1981

A measure of cognition within the context of assertion.

Described the development and evaluation of a measure of cognitive belief systems and thinking styles within the context of assertion. The Cognition Scale of Assertiveness comprises eight items and is scored on a 7-point (disagree-agree) scale. In a series of studies, normative, reliability, and validity data were obtained for junior college, university, and nonstudent samples (N = 482). Reliability and validity results were poor for junior college students, but impressive data obtained for university and nonstudent populations. Further, cognition scores for these latter two groups discriminated high vs. low social anxiety, a factor often linked to assertion. Finally, the instrument was sensitive to change via assertion training. Overall, the present findings recommend the use of the Cognition Scale of Assertiveness as a reliable and valid measure of cognitive assertion for university students and for nonstudent samples.

Adolescent↗

PubMedDate not supplied

Saying "no" to environmental tobacco smoke: determinants of assertiveness among nonsmoking employees.

BACKGROUND: Nonsmokers' assertiveness can help regulate smoking in worksites by enhancing the salience of nonsmoking social norms. This study examined determinants of employees' assertiveness toward smoking colleagues. METHODS: Cross-sectional data were collected from 898 nonsmoking Dutch employees. Potential determinants were chosen using the attitude-social influence-efficacy model. RESULTS: Fifty-one percent of nonsmoking employees asked co-workers not to smoke. Assertive respondents had colleagues who more often acted assertively toward smokers at work, had a more positive attitude to asking colleagues not to smoke, and had a higher perceived self-efficacy. Moreover, assertive employees more often perceived hindrance from environmental tobacco smoke (ETS) and had more negative beliefs about ETS at work. CONCLUSIONS: What matters is whether ETS is perceived as bothersome and harmful. It is likely that both conditions must be met for nonsmokers to behave assertively. Worksite educational programs could focus more on increasing nonsmokers' awareness of the harmfulness of regular exposure to ETS at work to increase social pressure on employees who smoke in places that are shared by smokers and nonsmokers. However, the effectiveness of such strategies is yet unknown.

Adult↗