Health Locus of Control in problem drinkers with and without liver disease

Social capital and lack of belief in the possibility to influence one's own health: A population-based study

Objectives: To study the impact of social capital (social participation and trust) on lack of belief in possibility to influence health. Methods: The Scania 2000 public-health survey is a cross-sectional, postal questionnaire study including 13,604 persons aged 18—80 years which was conducted in 2000 by the regional healthcare authorities in Region Skåne, southern Sweden, to investigate health-related risk factors in the population. A logistic regression model was used to investigate the association between social capital and lack of belief in possibility to influence health. The multivariate analyses analysed the importance of confounders on the differences in lack of belief in possibility to influence health according to the social capital variables. Results: In total, 31.0% of all men and 33.5% of all women lack belief in the possibility to influence their own health. Lack of belief in possibility to influence health was positively associated with both low social participation and low trust, although stronger for social participation than for trust. Conclusions: Low levels of social capital, particularly low social participation, is positively associated with lack of belief in the possibility to influence one's own health.

Food addiction: an examination of the diagnostic criteria for dependence

The evidence for food's addictive properties is steadily growing. In addition to clinical and evolutionary plausibility, the possibility of addiction to food is supported by animal model research and increasingly by research with humans. Much as classic drugs of abuse "hijack" the brain, accumulating evidence with food suggests a similar impact, but with weaker effects. Although neurobiological evidence for food addiction is compelling, dependence as conceptualized with respect to alcohol and other drugs of abuse is fundamentally a behavioral disorder. Thus, we review the current state of food addiction research in the context of each of the diagnostic criterion for dependence (ie, tolerance, withdrawal, loss of control) and briefly explore other relevant addiction topics such as expectancies, reinforcement, and incentive salience. There is substantial evidence that some people lose control over their food consumption, suffer from repeated failed attempts to reduce their intake, and are unable to abstain from certain types of food or reduce consumption in the face of negative consequences. Although there is some evidence for other dependence criterion, further research is needed to examine tolerance and withdrawal to high-fat sweets, time spent in obtaining, using, and recovering from excess food consumption and the degree to which important activities are given up due to overconsumption. As science continues forward and both the public and elected leaders become aware that food may trigger an addictive process, this information will likely be used to inform policy. Thus, researchers need to carefully consider the implications of their work and the way in which the results may be interpreted.

Marital status, social capital and health locus of control: a population-based study

OBJECTIVES

To investigate the association between marital status and lack of internal health locus of control (HLC), taking economic stress and trust into account.

STUDY DESIGN

Cross-sectional study.

METHODS

The public health survey Skåne 2008 is a postal questionnaire study (55% participation rate). A random sample was invited to participate, and 28,198 individuals aged 18-80 years agreed. Logistic regression models were used to discern associations between marital status and lack of internal HLC. The multiple regression analyses included age, country of birth, education, economic stress and 'horizontal' trust.

RESULTS

In total, 33.7% of the men and 31.8% of the women lacked internal HLC. After age-adjustments, the unmarried and divorced men and the widowed women displayed significantly higher odds ratios of lack of internal HLC. The significantly higher odds ratios only remained for unmarried men throughout the multiple analyses. In contrast, divorced women had significantly lower odds ratios of lack of internal HLC than married women after adjustments for economic stress.

CONCLUSIONS

Health promotion regarding HLC and related behaviours should consider men and women who are not cohabiting. Health promotion should particularly consider unmarried men due to their higher propensity to lack internal HLC. The economic conditions and exposure to economic stress among widowed and divorced women should also be highlighted.

The epidemiology and clinical characteristics of patients with newly diagnosed alcohol-related liver disease: results from population-based surveillance

GOALS

We describe the epidemiology of outpatients newly diagnosed with chronic alcoholic liver disease and describe predictors of cirrhosis and referral for specialty care.

BACKGROUND

Alcohol is a major cause of liver disease in the United States. Most previous work has described hospitalized patients.

STUDY

Participants were identified through prospective population-based surveillance in gastroenterology practices Multnomah County, Oregon and New Haven County, Connecticut; and primary care and gastroenterology practices from Kaiser Permanente Northern California in Alameda County during 1999 to 2001. Patients were interviewed, a blood specimen obtained, and their medical record reviewed.

RESULTS

We identified 82 patients from gastroenterology practices with newly diagnosed alcoholic liver disease. Their median age was 50.0 years. 72.0% were male and 79.3% were White. The median age at initiation of alcohol use was 17.0 years. 43.9% of patients had evidence of cirrhosis at the time of diagnosis. Only 40.2% reported alcohol as the cause of their liver disease. Patients with cirrhosis were more likely to be older, have a higher median number of years of heavy alcohol consumption, and to have been hospitalized for a liver-related complication than noncirrhotic patients. An additional 83 primary care patients were more likely to be older, to be drinking alcohol at study interview, and to not have cirrhosis than patients referred for gastroenterology care.

CONCLUSIONS

Patients with alcoholic liver disease may present at a late stage and may not identify alcohol as a cause for their liver disease. Improved patient screening and education may limit morbidity and mortality.

The role of insight to alcohol use disorders in insight to schizophrenia

The aims of this study were to examine the difference in the level of insight into schizophrenia between patients with schizophrenia with and without comorbid alcohol use disorders (AUDs) and to examine the association between insight into schizophrenia and insight into AUDs in patients with comorbid schizophrenia and AUDs. A total of 51 schizophrenic subjects with comorbid AUDs and 67 schizophrenic subjects without AUDs were recruited into this study. The Schedule of Assessment of Insight-Expanded Version and the Hanil Alcohol Insight Scale were used to measure subjects' insight into schizophrenia and AUDs, respectively. Multiple regression analysis models were used to examine the association between insight into schizophrenia and comorbid AUDs in all subjects, as well as the association between insight into schizophrenia and insight into AUDs in the subjects with comorbid schizophrenia and AUDs. The results indicated that schizophrenic subjects with comorbid AUDs had a lower level of insight into schizophrenia than those without AUDs. Meanwhile, among subjects with comorbid schizophrenia and AUDs, those who had a higher level of insight into AUDs had a higher level of insight into schizophrenia. Based on the results of this study, we suggest that evaluating comorbid AUDs and the level of insight into AUDs is important when evaluating the level of insight into schizophrenia among patients with comorbid schizophrenia and AUDs.

Preliminary validation of the Yale Food Addiction Scale

Previous research has found similarities between addiction to psychoactive substances and excessive food consumption. Further exploration is needed to evaluate the concept of "food addiction," as there is currently a lack of psychometrically validated measurement tools in this area. The current study represents a preliminary exploration of the Yale Food Addiction Scale (YFAS), designed to identify those exhibiting signs of addiction towards certain types of foods (e.g., high fat and high sugar). Survey data were collected from 353 respondents from a stratified random sample of young adults. In addition to the YFAS, the survey assessed eating pathology, alcohol consumption and other health behaviors. The YFAS exhibited adequate internal reliability, and showed good convergent validity with measures of similar constructs and good discriminant validity relative to related but dissimilar constructs. Additionally, the YFAS predicted binge-eating behavior above and beyond existing measures of eating pathology, demonstrating incremental validity. The YFAS is a sound tool for identifying eating patterns that are similar to behaviors seen in classic areas of addiction. Further evaluation of the scale is needed, especially due to a low response rate of 24.5% and a non-clinical sample, but confirmation of the reliability and validity of the scale has the potential to facilitate empirical research on the concept of "food addiction".

Psychosocial work conditions, unemployment and health locus of control: a population-based study

AIMS

To investigate the association between psychosocial work conditions, unemployment and lack of belief in the possibility of influencing one's own health.

DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS

The 2000 public health survey in Scania is a cross-sectional postal questionnaire study with a 59% participation rate. In total, 5180 persons aged 18-64 years who belonged to the workforce and the unemployed were included in this study. Logistic regression models were used to investigate the associations between psychosocial factors at work and unemployment, and lack of belief in the possibility of influencing one's own health (external locus of control). Psychosocial conditions at work were defined according to the Karasek-Theorell demand-control/decision latitudes into relaxed, active, passive, and job strain categories. The multivariate analyses included age, country of birth, education, economic stress, and social participation.

RESULTS

In total, 26.6% of all men and 26.9% of all women lack an internal locus of control. The passive, job strain and unemployed categories have significantly higher odds ratios of lack of internal locus of control, as compared to the relaxed reference category. No such significant differences are observed for the active category. These patterns remain in the multivariate models, with the exception of the passive and unemployed categories among men, in which the significant differences disappear.

CONCLUSIONS

Psychosocial work conditions and unemployment may affect health locus of control. The control dimension in the Karasek-Theorell model seems to be of greatest importance.

Socioeconomic, psychosocial, behavioural, and psychological determinants of BMI among young women: differing patterns for underweight and overweight/obesity

OBJECTIVES

Underweight, overweight, and obese women aged 18-34 years were compared with normal weight women of the corresponding age according to socioeconomic, psychosocial, health behaviour, self reported global and psychological health, and locus of control characteristics.

METHODS

The 2000 public health survey in Scania is a cross-sectional study. A total 13,715 persons aged 18-80 years, of which 1967 were females of 18-34 years of age, were included in this study. They answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model adjusted for age was used to investigate the association between socioeconomic, psychosocial, health behaviour, self reported global and psychological health, locus of control, and the BMI categories.

RESULTS

A 17.5% proportion of the women, aged 18-34 years, were underweight (BMI < 20.0), 18.4% were overweight, and 7.0% obese. The prevalence of underweight according to the BMI < 18.5 definition was 5.8% among women aged 18-34 years. Women who were underweight had significantly higher odds ratios for overtime work, being students, low emotional support, and poor self reported global as well as poor psychological health than normal weight women. Women who were overweight/obese were unemployed, had low education, low social participation, low emotional and instrumental support, were daily smokers, had a sedentary lifestyle, had poor self reported global health, and had lack of internal locus of control compared with normal weight women.

CONCLUSIONS

Underweight women are more likely to have poorer psychological health than normal weight women. In contrast, overweight and obese women are more likely to have poor health related behaviours and lack of internal locus of control compared with normal weight women. These differing patterns suggest both different etiology and different preventive strategies to deal with the health risks of people who are underweight as opposed to those who are overweight/obese.

Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

CONTEXT AND OBJECTIVE

For some patients who have developed significant alcohol-related physical disease, total abstinence from alcohol may offer the best chance of survival. The aim of this study was to investigate motivation for treatment in two groups of alcohol users: outpatients from the gastroenterology clinic and outpatients from the specialist alcohol treatment service.

DESIGN AND SETTING

Cross-sectional study, at a federally funded public teaching hospital.

METHODS

The sample studied was 151 outpatients from the gastroenterology clinic and 175 from the specialist alcohol treatment service. The interview was conducted in the outpatient clinics at the first appointment, and consisted of demographic questions and scales for measuring quality of life, alcohol dependence, pattern of alcohol, motivation for treatment and consequences of alcohol consumption.

RESULTS

The results suggested that outpatients from the gastroenterology clinic were less dependent on alcohol, had suffered fewer consequences from alcohol and had fewer emotional and mental health problems than did the outpatients from the alcohol treatment service. In relation to their stages of change, the gastroenterology outpatients presented high precontemplation scores at the beginning of treatment while outpatients of alcohol treatment service showed higher scores in contemplation, action and maintenance.

CONCLUSION

The medical treatment may be a reason for the temporary alcohol abstinence behavior among the gastroenterology outpatients.

A pilot study of an alcoholic liver disease recurrence prevention education program in hospitalized patients with advanced liver disease

No systematic work has been completed to assess whether or not educational programming might exert lifestyle improvements among alcoholic liver disease (ALD) inpatients. The present pilot study sought to answer this question through the use of a small-scale two-group experiment (five-session education program versus standard care) at a state-of-the art Liver Unit that provided tertiary care of indigent patients with advanced ALD. A total of 44 patients were initially randomly assigned to program conditions, and 25 provided 3-month follow-up data (13 in the program condition, 12 in the control condition). Patients who received the program reported high receptivity to it, and showed greater learning of program material and reported greater lifestyle changes than the control patients. For those ALD inpatients that are able and willing to participate, the program shows promising effects on self-reported lifestyle change.

Alcoholic liver disease (ALD): a new domain for prevention efforts

Alcoholic liver disease (ALD) is a leading cause of death; yet relatively little has been written about it in the health behavior research literature. This paper will describe ALD, what factors predict ALD including findings from analyses of the 1998 state of California and Los Angeles County hospital discharge data, and possible means of preventing this disease. It is hoped that new interest among health behavior researchers and practitioners will be stimulated.

Locus of control for general health and STD acquisition among adolescent girls

PURPOSE

To examine adolescent girls' perception of control over general health and sexually transmitted disease (STD) acquisition.

METHODS

Adolescents participating in a longitudinal study were asked questions regarding their perception of their locus of control. These questions, adopted from a previous measure, focused on six loci: internal control, control by parents, partners, peers, and health care providers, and chance.

RESULTS

There were 128 girls (mean age, 17 years; range, 14.5 to 18.8); 82% were black and 18% white. Statistically significant associations were found between control of general health and STD acquisition for each locus of control subscale, with the exception of partner control. However, the girls reported significantly less control over STD acquisition than over general health for health care providers, parents, and by chance, and significantly more partner and internal control over STD acquisition than general health. The correlations between parental control over general health and over STD acquisition were inversely correlated with age. Partner control was positively related to current condom use, but internal control was not.

CONCLUSIONS

The degree of the locus of control was specific for STD acquisition. Girls who believe they should be able to control STD acquisition may not be using condoms. The view of partners as having control over STD acquisition may represent joint communication or coercion. However, in general these findings support the development of female-controlled methods for STD prevention, such as topical microbicides.