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Cognitive-Affective Inconsistency and Ambivalence: Impact on the Overall Attitude-Behavior Relationship.

ABSTRACT: This research explored whether overall attitude is a stronger predictor of behavior when underlying cognitive-affective inconsistency or ambivalence is low versus high. Across three prospective studies in different behaviors and populations (Study 1: eating a low-fat diet, N = 136 adults, eating five fruit and vegetables per day, N = 135 adults; Study 2: smoking initiation, N = 4,933 adolescents; and Study 3: physical activity, N = 909 adults) we tested cognitive-affective inconsistency and ambivalence individually and simultaneously as moderators of the overall attitude-behavior relationship. Across studies, more similar effects were observed for inconsistency compared with ambivalence (in both individual and simultaneous analyses). Meta-analysis across studies supported this conclusion with both cognitive-affective inconsistency and ambivalence being significant moderators when considered on their own, but only inconsistency being significant when tested simultaneously. The reported studies highlight the importance of cognitive-affective inconsistency as a determinant of the strength of overall attitude.

SUBMITTER: Conner M

PROVIDER: S-EPMC7961742 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Cognitive-Affective Inconsistency and Ambivalence: Impact on the Overall Attitude-Behavior Relationship.

Conner Mark M Wilding Sarah S van Harreveld Frenk F Dalege Jonas J

Personality & social psychology bulletin 20200804 4

This research explored whether overall attitude is a stronger predictor of behavior when underlying cognitive-affective inconsistency or ambivalence is low versus high. Across three prospective studies in different behaviors and populations (Study 1: eating a low-fat diet, N = 136 adults, eating five fruit and vegetables per day, N = 135 adults; Study 2: smoking initiation, N = 4,933 adolescents; and Study 3: physical activity, N = 909 adults) we tested cognitive-affe ...[more]

PMID: 32749192

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Project description:BackgroundCognitive control problems have been implicated in the etiology and maintenance of mental health problems, including depression, in adults. Studies in adolescents have been more equivocal, with some showing changes in cognitive control in adolescents with mental health problems, whereas others fail to show an association. This study examines whether adolescent mental health is associated with affective control, the application of cognitive control in affective contexts, which shows more protracted development than cognitive control.MethodsThe present study investigated the association of cognitive and affective control with depressive symptomatology and self-reported diagnostic history of mental health problems in adolescents. The study included 1929 participants (M age = 13.89) from the Future Proofing Study (N = 6,388, 11-16 years), who completed affective (incl., affective stimuli) and/or cognitive (incl., neutral stimuli) versions of a working memory (backward digit-span) and/or shifting (card-sorting) task at least once within 3 weeks of assessing mental health.ResultsPoorer working memory was associated with greater depressive symptomatology in adolescents (β = -0.06, p = .004), similarly across cognitive and affective control conditions (β = -0.02, p = .269). Adolescents with self-reported diagnostic history of mental health problems had significantly poorer shifting ability in affective compared to cognitive control conditions (b = 0.05, p = .010), whereas for adolescents with no self-reported diagnoses, shifting ability did not differ between conditions (b = -0.00, p = .649).ConclusionsThe present analyses suggest that working memory difficulties, in particular, may be associated with the experience of current depressed mood in adolescents. Problems with affective shifting may be implicated in a range of mental health problems in adolescents. Given the ubiquitous need for efficient cognitive functioning in daily life, enhancing cognitive and affective control in adolescents may be a promising means of improving functioning across a range of domains, including affective functioning, and by extension, adolescent mental health.

Project description:BackgroundThere is growing interest in patient autonomy, and communication between physicians and patients has become the essential cornerstone for improving the quality of healthcare services. Previous research has concentrated on the direct effect of physician-patient communication on service outcomes. In the present study, we examined the influence among constructs in the service process and the impact on healthcare outcomes. The present study used behavioral theory to expand the process aspect of the Donabedian healthcare service quality structure-process-outcome model to examine the impact of cognitive changes and communication feedback on patients' adherence behavior. In addition, the moderating effect of hospital facility levels is examined.MethodsA conceptual model was developed and tested using a questionnaire administered to patients in eight hospitals. A total of 397 respondents returned usable surveys, with a response rate of 92.11%. Structural equation modeling was used to analyze the data in two steps that involved a measurement model and a structural model. The former was applied to estimate the Cronbach's alphas, intercorrelations of factors, and descriptive statistics; the latter was used to test the hypothesized relationships of the constructs.ResultsThe results identified three mediators of the healthcare process within the healthcare services framework: physician-patient communication, cognitive efficacy, and adherence behavior. Physician-patient communication influenced cognitive efficacy (β = 0.16, p < 0.001), and cognitive efficacy influenced physician-patient communication (β = 0.18, p < 0.001). The effect of this bidirectional relationship on adherence behavior was positive (β = 0.38, p < 0.001). The healthcare structure influenced healthcare outcomes via these three healthcare process constructs. The adherence behavior of patients who were treated in the medical center has greater influences by the structure and physician-patient communication than it was treated in the regional hospitals.ConclusionsThis study revealed a complex pattern in relationships among process constructs for healthcare services. The findings of this study acknowledge the important potential interrelationships among the healthcare service constructs to improve the quality of healthcare outcomes.Trial registrationCRREC104107. Date: 22/01/2016. Prospectively Registered.

Project description:BackgroundAllergy documentation is frequently inconsistent and incomplete. The impact of this variability on subsequent treatment is not well described.ObjectiveTo determine how allergy documentation affects subsequent antibiotic choice.DesignRetrospective, cohort study.Participants232,616 adult patients seen by 199 primary care providers (PCPs) between January 1, 2009 and January 1, 2014 at an academic medical system.Main measuresInter-physician variation in beta-lactam allergy documentation; antibiotic treatment following beta-lactam allergy documentation.Key results15.6% of patients had a reported beta-lactam allergy. Of those patients, 39.8% had a specific allergen identified and 22.7% had allergic reaction characteristics documented. Variation between PCPs was greater than would be expected by chance (all p<0.001) in the percentage of their patients with a documented beta-lactam allergy (7.9% to 24.8%), identification of a specific allergen (e.g. amoxicillin as opposed to "penicillins") (24.0% to 58.2%) and documentation of the reaction characteristics (5.4% to 51.9%). After beta-lactam allergy documentation, patients were less likely to receive penicillins (Relative Risk [RR] 0.16 [95% Confidence Interval: 0.15-0.17]) and cephalosporins (RR 0.28 [95% CI 0.27-0.30]) and more likely to receive fluoroquinolones (RR 1.5 [95% CI 1.5-1.6]), clindamycin (RR 3.8 [95% CI 3.6-4.0]) and vancomycin (RR 5.0 [95% CI 4.3-5.8]). Among patients with beta-lactam allergy, rechallenge was more likely when a specific allergen was identified (RR 1.6 [95% CI 1.5-1.8]) and when reaction characteristics were documented (RR 2.0 [95% CI 1.8-2.2]).ConclusionsProvider documentation of beta-lactam allergy is highly variable, and details of the allergy are infrequently documented. Classification of a patient as beta-lactam allergic and incomplete documentation regarding the details of the allergy lead to beta-lactam avoidance and use of other antimicrobial agents, behaviors that may adversely impact care quality and cost.

Dataset Information

Cognitive-Affective Inconsistency and Ambivalence: Impact on the Overall Attitude-Behavior Relationship.

Publications

Cognitive-Affective Inconsistency and Ambivalence: Impact on the Overall Attitude-Behavior Relationship.

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