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PubMed2002

Smoke screen: an ethnographic study of a cigar shop's collective rationalization.

It is the purpose of this ethnographic study to explain why efforts from the medical establishment, the press, and friends and family are unsuccessful in persuading a group of men at a local cigar shop to stop smoking. I also seek to determine how these men create a linguistic defense shield that, ironically, protects them from the anxiety that such messages are designed to produce. I argue that the regulars at the shop collectively craft and share 6 prosmoking arguments that (a) rebuke the findings of the medical establishment, (b) anesthetize the regulars from the impact of antismoking messages, and (c) relieve cognitive dissonance and anxiety created by the act of smoking. I establish a theoretical foundation for the study, describe how the regulars craft and converge their collective narratives, and detail the 6 collectively created prosmoking narratives most frequently used by the regulars in countering antismoking messages.

Adult↗
PubMed2005

Motivational interventions for heavy drinking college students: examining the role of discrepancy-related psychological processes.

The authors examined the effects of a brief motivational intervention for heavy, episodic alcohol use on discrepancy-related psychological processes. Heavy-drinking college students (N=73) were randomly assigned to a motivationally based intervention (MBI) or an assessment-only control (AC) condition. Cognitive (actual-ideal discrepancy) and affective (2 forms of cognitive dissonance) discrepancy processes were assessed at baseline and immediately following the experimental manipulation. At 6-week follow-up, MBI participants demonstrated significantly greater reductions in problematic drinking than AC participants. Moreover, actual-ideal discrepancy and negative, self-focused dissonance were significantly increased following the intervention (discomfort-related dissonance was not) and were correlated with outcome alcohol involvement. These discrepancy processes did not, however, mediate the relationship between condition and outcome. The findings lend some support to the role of discrepancy enhancement in drinking-related behavior change among college students.

Adolescent↗
PubMed1995

A study of the perception and experiences of critical care nurses in caring for potential and actual organ donors: implications for nurse education.

This paper describes a research study designed to explore the knowledge, perceptions and attitudes of practising critical care nurses towards caring for 'brain stem dead' cadaver organ donors and their families. The influence of formal nurse education and experiential learning were investigated together with what nurses felt could better prepare them for this role. Data were collected through self-completion questionnaires from 103 critical care nurses. This was instrumental in forming a semi-structured interview schedule whereby seven respondents were interviewed. The findings of the study suggest that nurses are very favourable towards organ donation and this correlated with their knowledge of brain stem death (P < 0.024). Nurses with between 6 and 10 years critical care experience had a significantly higher knowledge base (P < 0.05) than those of less or greater experience. Nevertheless, when challenged some nurses were less comfortable with the concept of brain stem death and caring for these patients. A degree of cognitive dissonance was identified. Discussion revealed that all nurses need to have a better understanding of their role in organ donation, no mater what nursing discipline they practice. This may help to expel some of the myths that have, undeservedly, become established and given the donor process a rather sinister image.

Brain Death↗
PubMedDate not supplied

Attitude change as a motivational factor in producing behavior change related to implementing primary nursing.

This study examined the relationship between nurses' improved attitudes toward the feasibility of primary nursing within the Veterans Administration setting and resultant behaviors directed at implementing primary nursing. Festinger's cognitive dissonance theory served as an explanatory model for observed outcomes. Improved attitudes motivated participants to engage in predicted behaviors. Findings implied that effective training is maximized in situations in which correspondence exists between the source of the behavioral deficiency and educational activities designed to remedy the deficiency.

Attitude of Health Personnel↗
PubMed2004

Bias at the racetrack: effects of individual expertise and task importance on predecision reevaluation of alternatives.

These studies were designed to test cognitive dissonance theory's assertion that alternatives are not reevaluated before a choice. Participants viewed information about horses in a simulated race and rated each one's chance of winning three times before placing their bet and once after placing it. It was found that ratings of the chosen horse increased within the predecision period as well as after betting. Predecision bolstering occurred even when participants did not expect to bet, and predecision preference increased with task importance and participant expertise. The findings are attributed to maintenance of consistency throughout a cognitive system.

Adult↗
PubMed1977

Observers' focus of attention in the simulation of self-perception.

This research was designed to assess the effects of a manipulation of observers' focus of attention--from a focus on the actor to a focus on the actor's situation--upon observers' attributions of attitude to an actor in a simulation of a forced-compliance cognitive dissonance experiment. Observers induced through empathy instructions to focus attention on the actor's situation inferred less actor attitude positivity than did observers given no specific observational set. In addition, situation-focused observers inferred that the actor's attitude was directly related to reward magnitude, whereas actor-focused observers inferred that the actor's attitude was inversely related to reward magnitude. An extension of self-perception theory, offered as an interpretation of these and other results, suggested that motivation attribution made by actors and observers in dissonance and simulation studies are dependent on focus of attention. The attributions made by actor-focused observers simulate those of objectively self-aware actors and are based upon perceived intrinsic motivation; the attributions of situation-focused observers simulate those of subjectively self-aware actors and are based upon perceived extrinsic motivation.

Attention↗
PubMed1986

Patient compliance and medication perception.

The problem of patient/client noncompliance with regimens of prescribed medication is addressed, with attention to the incidence and illogical nature of this behavior. The psychological theory of cognitive dissonance is suggested as appropriate to an understanding of some aspects of noncompliance because medicinal preparations represent stimuli that are not necessarily neutral. A medication's perceptual properties may have important and specific meanings for patients or clients that may support or detract from compliance. Recent research and empirical evidence that reflects on this concept are reviewed. With further efforts, it may be possible to enhance compliance through perceptual engineering.

Cognitive Dissonance↗
PubMedDate not supplied

Behavior modification in the treatment of hypertension.

This study examines the use of a behavior modification program as an adjunct to the medical treatment of essential hypertension. The subjects, outpatients with medically treated, but uncontrolled, essential hypertension, were exposed to group interaction (including such processes as peer reinforcement, peer competition, and cognitive dissonance), individual blood pressure monitoring, stimulus control, and direct social influence. The control subjects received only routine medical treatment for their hypertension. Results indicated that the experimental subjects significantly decreased their diastolic blood pressures between pre- and post-treatment measures (spanning a period of four weeks), whereas the control subjects showed no such change. Thus it appears possible to use behavior modification to help in the treatment of essential hypertension.

Behavior Therapy↗
PubMed1992

Caring for people with AIDS: nurses' attitudes and feelings.

A qualitative, non-experimental study was conducted to identify the feelings and attitudes that nurses associate with caring for people with AIDS. Data collection and analysis were guided by the phenomenological method. Cognitive dissonance theory served as the theoretical framework to view the experience of caring for someone with AIDS. Data analysis of audiotaped, semi-structured interviews resulted in the identification of six mutually inclusive as well as exclusive themes which represent the attitudes and feelings of nurses: fear, anger, sympathy, self-enhancement, fatigue and helplessness. Particularly evident were differences in the way respondents perceived and treated AIDS patients who are intravenous drug users and those who are homosexuals.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Learning support for the consultation: information support and decision support should be placed in an educational framework.

BACKGROUND: Advances in information technology mean that it is now possible to provide contextually relevant, evidence-based information during the course of the consultation. As a consequence, the practitioner has to consider the new information (from the computer) in the situation of the present consultation and in the light of his or her own experience. This task has to be carried out in a short time, in the presence of the patient. METHOD: Drawing on experience of the development of one decision support system, this paper places that task for the practitioner in an educational framework. We begin by reviewing theories of professional experience and knowledge and go on to look at schema theory and the role of cognitive dissonance and reflection in learning. CONCLUSION: This paper considers the provision of real time decision support in the light of learning and the experienced practitioner. We conclude that framing the implementation of decision support in this way provides useful insights. The key process is learning by the practitioner, in the course of the consultation. This process should be supported by decision support and information support software. There are implications here for the design of such software, and also for the way in which practitioners are trained to use it.

Cognitive Dissonance↗
PubMed1978

The mechanisms underlying attributive projection.

The experiment investigated the validity of the cognitive dissonance reduction and stimulus generalization explanations of attributive projection. Subjects in a high dissonance condition were informed that they possessed considerable hostility (a negative trait), while those in a low dissonance condition were told that they possessed a great deal of assertiveness (a desirable trait). The dissonance mechanism received support in that (a) subjects' reports of their anxiety indicated that an ego threat was produced only in the high dissonance condition, as expected; and (b) hostility was projected onto others to a significantly greater degree than was assertiveness. The existence of only a weak relationship between degree of ego threat produced by the personality feedback and subsequent amount of projection, however, throws into question the validity of the hypothesized defensive function of projection. No support for the generalization mechanism was obtained since the subjects did not project a greater amount of either trait onto the similar targets (college students) than onto the relatively dissimilar targets (middle-aged lawyers); possible reasons for this negative result were discussed, as well as suggestions for future research.

Anxiety↗
PubMed2001

Student nurses' experiences of caring for patients in pain.

Poor pain assessment contributes to inadequate pain relief. Studies in the United States have shown that while student nurses become more sensitive to psychological distress during training, they become less sensitive to pain. However, a recent study by the authors in the United Kingdom found that while inferences of psychological distress increased there was no change in inferences of pain over the common foundation programme. This study set out to explore their experiences of caring for patients in pain during the first 18 months of their training in order to understand how these experiences might affect their sensitivity to patient's pain. Interviews with 15 students following their common foundation programme showed that they experienced a wide range of strong emotions when caring for patients in pain. Their relatively junior status in the wards seemed to place them in difficult positions and provided them with little support. Theories of desensitisation, cognitive dissonance and acculturation have been proposed to explain decreasing sensitivity to pain. The lack of a significant change in students' inferences of pain and the analysis of their interviews suggest that their experiences are more varied than these theories suggest. The students experiences echo those found in previous studies relating to the socialisation of student nurses and emotional labour (Melia, 1987. Learning and Working. The Occupational Socialization Nurses. Tavistock Publishers, London; Smith, 1992. The Emotional Labour of Nursing. Macmillan, London). These findings have important implications for both nurse education and the mechanisms to support student nurses in clinical practice.

Acculturation↗
PubMed1989

Perceptions of immunity to disease in adult smokers.

Public education has ensured smokers' awareness of the health risks of smoking. It has been suggested that engaging in a behavior (e.g., smoking) which one knows to be dangerous will result in an unpleasant state of "cognitive dissonance." Smokers may deal with such a state by denying the dangers of smoking. In this study, 97 smokers and 95 nonsmokers (age range, 15-65 years) rated the risk to themselves and to the average Australian smoker of contracting three smoking-related diseases. Evidence supportive of denial of risk was found: smokers' ratings of the risk to the average smoker were lower than nonsmokers' ratings, and smokers' ratings of their own risk were lower still. Such denial of risk may undermine the effectiveness of stop-smoking campaigns which focus on health aspects of smoking, and methods of dealing with this problem are discussed.

Adolescent↗
PubMed1992

Genetic counselor attitudes towards fetal sex identification and selective abortion.

Thirty-four prenatal genetic counselors (all but one non-M.D.s) in seven American cities were interviewed on attitudes which might plausibly affect counselor-client interchanges. They overwhelmingly endorse both non-directive counseling and the pro-choice ethos which supports a woman's absolute right to abortion in the early stages of pregnancy. However, they also overwhelmingly condemn using prenatal diagnosis for sex selection purposes. Therefore, counselors experience continual stress from clients who evoke the conflict inherent between these two stances. Counselors use a variety of coping mechanisms to minimize this cognitive dissonance. Avoidance through out-referral or invoking institutional policies forbidding prenatal diagnosis for sex selection purposes is a diminishing option and not possible with clients who have or offer a medical indication. More common is the use of psychological coping mechanisms. By elevating the ideals of non-directiveness and female autonomy counselors better tolerate client values in conflict with their own. Some redefine the category of 'unwanted pregnancy' to include fetuses of the 'wrong sex'; others redefine the problem as their own ethnocentricism. Empowering counselors to set the protocols they use to screen applicants for prenatal diagnosis would not remove these conflicts. Many counselors believe a ban on releasing fetal sex information while abortion is still a legal option would be organizationally or legally unacceptable, or a violation of patient automony. A complicating factor is that 60% of the counselors interviewed would prefer to know fetal sex in their own pregnancies. Counselors reflect the ambivalence of American society in balancing conflicting social goals.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Legal↗
PubMed2000

Part 2: Fear of contagion, fear of intimacy.

In this second part of the trilogy, I review the concepts of panic, the Theory of Cognitive Dissonance, and how internally inconsistent opinions and attitudes can be made consistent (or consonant). The theory explains, in some measure, how AIDS has been socialized into our thinking about identity, and goes beyond a medical condition. The pervasive identification of gay men with HIV and AIDS has resulted for many in an over-identification with fears of contagion and on a societal level in a fear of all gays as pools of contagion. The conversion of dissonance to consonance has taken many forms; within the gay community it has resulted in the rejection of the "100% safe-100% of the time" safe-sex message, and the adoption (for many) of a new form of deviant label-someone who is not in conformity with the social norm of gay community sexual behavior. However, we shall see that this so-called norm is a sham-that many gay men do not, as a rule, practice safe(r) sex on a consistent basis. This information indicates that the educational efforts of the last decade have at best lost their potency, and at worst were less than efficacious to begin with. The dissonant messages have also informed both the construction of the gay community and its interpretation of what it means to be gay. The result has been a tri-lateral perception of HIV and AIDS as either a medical, political or a social phenomenon. This fragmented understanding has exacerbated the already polarized ASOs and GSOs in that each has determined its ideology based on a particular interpretation of HIV and AIDS. This polarization has been operationalized by the GSOs and ASOs primarily in the manner by which they define their target markets, and more importantly, in the manner by which they exclude certain gays from participation. At the extreme, some gay men feel entirely left out of the community, and are consequently unable to convert their dissonance regarding being gay into consonance, if only by developing some associational ties with the community. The central question of the sustainability of the gay movement is thus partly answered by restating the nature of the fractures in the community. Kiesler's determinants regarding change relate directly to the sustainability question-can GSOs and ASOs, given their pluralistic ideologies and constituencies, break free of the constraints that are posed by these determinants? Would the adherents and conscious constituents defect from their organizations, and form new ones (thus reifying the fractures that already exist)? On the other hand, is there a sense of community and identity that will function as a bonding agent to encourage coalition building and social reorganization? The matter may turn on the issue of selective rewards: can a coalition of ASOs and GSOs provide staff, volunteers and clients sufficient motivation for making the inevitable compromises? Given the selective nature of the rewards, as they now stand, the probability of being able to so do is remote. The influence of the non-gay community, as well as the attitudes and beliefs of the majority of gays who do not belong to any gay organizations, hampers success.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Theories and models supporting prevention approaches to alcohol problems among youth.

The Alcohol, Drug Abuse, and Mental Health Administration's Office for Substance Abuse Prevention (OSAP) was established to initiate programs to provide prevention and early intervention services for young people, especially high-risk youth. OSAP's starting point was the theories and models that provide the background body of knowledge. The models summarized here guide new prevention efforts and provide a framework for analyzing diverse experiences in the field. The goal has been to develop strategies based on theories and models of prevention that can reverse or prevent adolescent alcohol use. Among the psychosocial models, research in social learning theory is the theoretical basis for prevention efforts using the team approach among individuals, small groups, families, and communities. A prevention technique based on cognitive dissonance theory proposes verbal inoculations to establish or strengthen beliefs and attitudes, helping a young person to resist drinking, which may be in conflict with another, more desirable goal. In the developmental concept adolescence is a period of role confusion out of which the person's identity should emerge. Prevention efforts built on this view seek to help adolescents to form positive identities by achievement as students, athletes, and in community roles. Behavioral intention theory provides a framework for understanding the role of perceived social norms in directing behaviors. In the social development model, prevention programs should create positive peer groups and ensure that the social environment does not give mixed messages. Health behavior theory is the basis for prevention strategies directed toward a person's entire behavior instead of one aspect. The stages of the drug involvement model form the basis for prevention programs providing early intervention directed at the so-called gateway drugs.Among the communications models, the health promotion concept advocates a comprehensive approach in developing health campaigns and attention to the five major elements of the communications process. Mass media campaigns based on the communication-behavior change concept address the steps required to move a target population from initial awareness of interest in a problem to the adoption and maintenance of advocated attitudes or behaviors.Among public policy models, researchers have concluded that higher real prices on alcohol and restricted availability have the effect of lowering alcoholic beverage consumption among young people and the incidence of heavy and frequent drinking.Raising the minimum age for purchase has been found to reduce the rate of automobile accidents involving young persons. Essential components of prevention strategies and approaches are presented.

Adolescent↗
PubMed2004

Effects of priming thoughts about control on anxiety and food intake as moderated by dietary restraint.

The study was designed to examine: (a) if activating thoughts about control affects anxiety and food intake and (b) if those effects are moderated by dietary restraint. Eighty female undergraduates were administered the Dietary Restraint questionnaire and were primed for cognitions of control or of lack of control. The participants' perceptions of control over food consumption, their state anxiety, and their food intake as part of an alleged taste-test, were assessed. As evidence for the effectiveness of priming, participants reported less control over food consumption after being primed for lack of control than for control cognitions. As expected, Restraint score was negatively correlated with perceived control over food consumption. Consistent with hypothesis, participants high in dietary restraint experienced greater anxiety after being primed for control than after priming for lack of control, whereas participants low in dietary restraint displayed the opposite pattern. These findings were consistent with the cognitive dissonance principle that individuals experience greater anxiety when cognitions are inconsistent with personal beliefs than when they are consistent. As expected, priming thoughts of lack of control resulted in greater food intake than did priming thoughts of control, supporting the hypothesis of a nonconscious, automatic link between cognitions and food intake.

Adult↗
PubMed1992

Distraction, choice and self-esteem effects on cognitive response facilitation.

From an integration of distraction-conflict theory and cognitive dissonance theory, it was hypothesized that distraction would increase, rather than disrupt, the proarguing of persons who had been given high choice to engage in discrepant behaviour, and would increase, rather than disrupt, the counterarguing of persons who had been given low choice to engage in such behaviour. Furthermore, it was expected that this cognitive response facilitation effect would more likely occur for persons high in self-esteem. The results supported the hypotheses and were interpreted as also confirming the notion that dissonance-related processes occur at the cognitive response level.

Adult↗