Psychological reactance and adolescent cannabis use: The role of parental warmth and monitoring.

Psychological reactance (PR) is a psychological state or trait typified by resistant responses to threats to behavioral freedom. PR has been linked with negative health behaviors, including risky substance use; however, factors that may foster approaches to mitigate the impact of PR on these behaviors, as well as rejection of other health promotion communications is less understood. The current studies examined relations between parental warmth and monitoring with trait PR and responses to preventive cannabis communications and usage intentions. Two in-school surveys were administered to two difference samples of middle school students (Study 1, N = 1,416; Study 2, N = 1,118). Path analytic models tested multivariable linkages among relevant parenting variables, PR, and outcomes associated with cannabis use. Follow-up regression analyses explored significant interaction effects. In Study 1 (p <0.001) and Study 2 (p <0.01), parental warmth moderated the relation between monitoring and trait PR: High monitoring was a protective factor only when combined with high warmth. In turn, PR mediated the relationships between parenting practices and cannabis intentions in both studies (p <0.001). In Study 2, PR also was linked with resistance to persuasion via more unfavorable reactions to anti-cannabis appeals (p <0.001). Findings indicated that low parental warmth combined with high parental monitoring was associated with high trait reactance in adolescents, which predisposed them to stronger resistance to preventive communications. Interventions might focus on counseling parents about the likely outcomes of parenting style, and ways to implement beneficial approaches.

Organ donation and departments of motor vehicles: Multiple messages, implementations, and replications.

OBJECTIVE: To reduce uncertainty about the effectiveness of Departments of Motor Vehicles (DMV) interventions, we assessed the influence of several DMV-based media campaigns on organ donor registration. METHOD: Across 4 studies, campaigns were implemented in 8 (Studies 1-3) or 9 (Study 4) New Mexico DMVs. Three theories guided message development (i.e., efficacy, altruism, vested interest). Donor registration was the outcome measure. RESULTS: In Study 1, both the efficacy (OR = 1.14) and altruism (OR = 1.11) campaigns resulted in significantly more registrations than the control condition and the vested interest campaign. In Study 2, the efficacy campaign (OR = 1.13) again resulted in significantly more registrations than the control and vested interest campaign. In Study 3, a new version of the efficacy campaign (OR = 1.21) and 2 new versions of the vested interest campaigns (OR = 1.12; 1.14) all resulted in significantly more registrations than the control condition. In Study 4, neither the efficacy campaign (OR = 1.06) nor a campaign that combined efficacy and vested interest materials (OR = 1.03) significantly increased registrations. A single-paper meta-analysis assessing these studies indicated all 3 appeals resulted in significantly greater registrations than the control (OR ranged from 1.06 to 1.13). CONCLUSION: Results indicate donor registration rates can be increased through DMV-based media campaigns; however, the appeal used, and the implementation of that appeal, can determine the likelihood of success. These results can guide the development and implementation of campaigns seeking to influence donor registration and other prosocial behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents.

Many past cannabis prevention campaigns have proven largely ineffective due in part to the diversity of adolescents' cannabis-relevant beliefs. The current studies evaluated the impact of a sequential multiple message approach tailored to the usage norms of adolescents expressing negative attitudes toward a cannabis prevention appeal. A multiple-message strategy was implemented-initial unfavorable message evaluations were invalidated using attitudinal rebuttal feedback prior to presenting a third tailored communication. Participants were cannabis-abstinent middle and high school students (ages 11 to 16). Study 1 (N = 808) compared effects of gain- and loss-framed messages tailored to each student's normative usage perceptions. In Study 2 (N = 391), students were randomly assigned to receive a tailored or non-tailored message after receiving feedback meant to destabilize anti-message attitudes. For at-risk adolescents in Study 1 who perceived cannabis use as normative, a tailored gain-framed message resulted in the lowest usage intentions (p < .05). In Study 2, a conditional multiple-moderated mediation model showed that for high-risk teens with normative beliefs and pro-cannabis attitudes, exposure to a tailored gain-framed communication was associated with decreased cannabis attitude certainty, and lower usage intentions 2 months later (p < .05). Findings have implications for sequential messaging utilization in mass media campaigns and support the efficacy of tailored messages over a one-size-fits-all media approach. Further, results suggest that systematically weakening resistance to persuasive communications and tailoring messages consistent with individually perceived peer norms is an effective prevention strategy.

It's all relative: Increasing organ donor registration intentions by maximizing family-relevant vested interest.

Guided by vested interest theory, the impact of educating potential organ donors about the beneficial experiences afforded to families of deceased donors was assessed. Participants were informed about these benefits by taking a survey that asked them to indicate both their awareness, and the appeal, of numerous existing benefits (e.g. grief services). We employed a double-sided mixed design. Both the true experimental design and the quasi-experimental repeated assessment indicated increased registration intentions. Only the quasi-experimental design indicated significant attitude change. This study provides evidence supporting the potential utility of focusing interventions on the benefits afforded to donor families.

Above the influence of vaping: Peer leader influence and diffusion of a network-informed preventive intervention.

Using social networks to inform prevention efforts is promising but has not been applied to vaping. To address this gap, we pilot tested the peer-led Above the Influence of Vaping (ATI-V) and examined diffusion through 8th grade networks in three schools. Fifty students, nominated and trained as Peer Leaders, implemented prevention campaigns informed by communication science, including gain-loss messaging and social norming. Across schools, 86-91% of students (N = 377) completed measures (pre-post) of electronic vaping product (EVP) use and attitudes, and named close friends and adults to construct social networks. Using baseline reports, we classified students as Recent EVP Users (10%), Vulnerable Nonusers (24%), or Resolute Nonusers (66%). Peer Leaders had reach through friendship connections to students at varying risk of vaping; 12-16 weeks after Peer Leaders were trained and began implementing campaigns, 79% of Resolute Nonusers and 74% of Recent Users/Vulnerable Nonusers reported exposure to a vaping prevention message. Students with more Peer Leader friends were less likely to report recent EVP use (OR = 0.41) or intention to use an EVP (B = 0.12) on post-surveys, supporting the intervention conceptual model positing diffusion through friendship networks. Use of student-nominated peer leaders was supported by network analyses showing EVP Users integrated within the friendship network, having more high-risk friends, and fewer adult connections. This evidence is the first to show that adolescent Peer Leaders with ongoing mentoring and science-informed campaigns can potentially reduce EVP acceptability and use. Areas for refining ATI-V include increasing consistency of campaign exposure across schools.

Selective invalidation of ambivalent pro-marijuana attitude components.

INTRODUCTION: Attitudes of drug-abstinent youth considering marijuana initiation can be highly ambivalent. Invalidating pro-usage elements (i.e., opinions) of ambivalent marijuana attitudes, while leaving anti-marijuana elements intact, may create stronger, less ambivalent marijuana-resistant attitudes and lower usage intentions, while concurrently elucidating the role of ambivalence in persuasive prevention. METHOD: From an initial pool of marijuana-abstinent middle-school students (N = 538), the quintile expressing the most negative attitudes toward a marijuana prevention appeal (N = 101) were randomly assigned to one of three conditions designed to invalidate pro-marijuana opinions. Analyses then tested their susceptibility to a second marijuana prevention appeal. RESULTS: Personally threatening messages were found ineffective, but appeals contesting resistant responses significantly decreased ambivalence (p < .01). Mediational analyses showed that this decreased ambivalence was associated with less favorable attitudes and lower marijuana usage intentions (both p < .001). An attribution-based manipulation increased ambivalence (p < .05), which was associated with positive usage intentions mediated through positive attitudes (both p < .001). CONCLUSION: Analyses elucidated the role of attitude ambivalence in prevention, providing a more complete understanding of potential facilitative use of ambivalence in prevention models based on prevention. Results support the further examination and use of methods that invalidate pro-marijuana opinions, thereby leading to greater susceptibility to subsequent prevention appeals.

Social mediation of persuasive media in adolescent substance prevention.

Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed 3 antimarijuana advertisements, each followed immediately by videotaped discussions involving 4 adults or 4 adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants' perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants' perceived control (both p < .02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p < .05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p < .05). The findings may facilitate development of more effective prevention methods that emphasize the importance of the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. (PsycINFO Database Record

The Potential (F)utility of a Passive Organ Donor Registration Opportunity: A Conceptual Replication.

CONTEXT: Approximately 22 people die each day in the United States as a result of the shortage of transplantable organs. This is particularly problematic among Spanish-dominant Hispanics. Increasing the number of registered organ donors can reduce this deficit. OBJECTIVE: The goal of the current set of studies was to conceptually replicate a prior study indicating the lack of utility of a lone, immediate and complete registration opportunity (ICRO). DESIGN AND SETTING: The study, a quasi-experimental design involving a total of 4 waves of data collection, was conducted in 2 different Mexican consulates in the United States. Guided by the IIFF Model (ie, an ICRO, information, focused engagement, and favorable activation), each wave compared a lone ICRO to a condition that likewise included an ICRO but also included the 3 additional intervention components recommended by the model (ie, information, focused engagement, and favorable activation). PARTICIPANTS: Visitors to the Mexican consulates in Tucson, Arizona, and Albuquerque, New Mexico, constituted the participant pool. MAIN OUTCOME MEASURE: New organ donor registrations represented the dependent variable. RESULTS: When all 4 components of the IIFF Model were present, approximately 4 registrations per day were recorded; the lone ICRO resulted in approximately 1 registration every 15 days. CONCLUSION: An ICRO, without the other components of the IIFF Model, is of minimal use in regard to garnering organ donor registrations. Future studies should use the IIFF Model to consider how the utility of ICROs can be maximized.

Anger, frustration, boredom and the Department of Motor Vehicles: Can negative emotions impede organ donor registration?

RATIONALE: The IIFF Model (Information, Immediate and Complete Registration Mechanism, Focused Engagement, Favorable Activation) offers a checklist of considerations for interventions seeking to influence organ donor registration behavior. One aspect of the model, favorable activation, recommends considering the emotional and motivational state of a potential donor registrant. Given that most donor registrations occur at the Department of Motor Vehicles (DMV), we considered whether emotions experienced while at the DMV could influence registration rates. OBJECTIVE: The current research effort investigated the emotions people experience while visiting the DMV, explored whether these emotions are associated with donor registration intentions, and experimentally assessed whether DMV experiences influence donor registration. METHODS: Three studies were conducted through Amazon's Mechanical Turk. In Study 1, we randomly assigned participants to either recall a prior DMV experience or to a comparison condition. Emotions associated with the recalled experiences were the dependent variable. Study 2 assessed the correlations between nine different emotions and donor registration intentions. Study 3 randomly assigned participants to recall a prior frustrating DMV experience or to a comparison condition. Intention to register to donate was the dependent variable. RESULTS: Study 1 found that recalling a prior DMV experience was associated with more negative and less positive emotions than the comparison condition. Study 2 found that increased levels of negative emotion could be problematic, as negative emotions were associated with decreased donor intentions. Study 3 found that recalling a frustrating DMV experience resulted in significantly lower intentions to register as an organ donor (vs. a control condition). CONCLUSION: Although not all DMV experiences are negative, these data indicated a relationship between the DMV and negative emotions; an association between negative emotions and lower donor registration intentions; and, a causal relationship between negative DMV experiences and decreased registration intentions.

The power of the proposition: frequency of marijuana offers, parental knowledge, and adolescent marijuana use.

BACKGROUND: The frequency with which adolescents are offered marijuana has been investigated as a predictor of marijuana use. The current study was designed to test whether the number of marijuana offers received provides an indirect path between parental knowledge and adolescents' marijuana use. METHODS: Data from the nationally representative National Survey of Parents and Youth were examined. Analysis 1 tested the association between frequency of being offered marijuana and adolescents' (N=4264) marijuana usage in the subsequent year. Analysis 2, spanning a three-year time frame, tested whether the frequency of marijuana offers at the second year of the panel study bridged the relationship between parental knowledge in Year 1 and marijuana use in Year 3. RESULTS: Analysis 1 indicated that the frequency with which adolescents were offered marijuana predicted usage one year later, after controlling for previous usage and nine other common predictors of marijuana use. Analysis 2 revealed an indirect relationship between parental knowledge and use through the number of marijuana offers the adolescent received. CONCLUSION: There was a strong link between the number of offers received and adolescents' future marijuana use. Higher parental knowledge predicted reductions in offer frequency, which was associated with lower levels of marijuana use. Reducing the number of marijuana offers an adolescent receives could serve as a useful focus for intervention programs targeting parents.

Barriers to living donation among low-resource Hispanics.

Hispanics are disproportionately affected by renal failure. Although living donation has been heralded as a potential means for alleviating the need for transplantable kidneys, a nuanced understanding of the obstacles faced by Hispanics is necessary. In our study, we conducted focus groups with 28 first-generation Spanish-dominant Hispanic renal patients. Although some of the barriers that emerged were akin to those reported in previous research (e.g., a lack of knowledge about the process), others were unique. Rarely chronicled barriers include the disqualification of family members because of medical issues, potential donors being unable to miss work, disqualification of family members who are undocumented, concern that potential donors cannot support their family if they donate, and declining social support because of illness. The interaction among this constellation of barriers makes living donation particularly difficult among this population. Investigations focused on the unique barriers faced by these low-resource individuals are warranted.

Differentiating Common Predictors and Outcomes of Marijuana Initiation: A Retrospective Longitudinal Analysis.

This quasi-experimental secondary analysis, funded by NIDA, employed data from a national sample of 1,968 US adolescents, collected from 1999 to 2003, self-classified as resolutely anti-marijuana on the first two yearly assessments (T1 and 2). At T3, respondents remained resolute non-users, or had moved to vulnerable non-use or use. Analysis of variance indicated that users at T3 were significantly heavier users of tobacco and alcohol, and reported significantly less intense parental monitoring, than those who did not initiate marijuana use. Furthermore, categorizing non-users as either resolute or vulnerable revealed behavioral patterns that otherwise would have been unidentified. Implications for prevention are discussed.

Attitude ambivalence, friend norms, and adolescent drug use.

This study assessed the moderating effects of attitudinal ambivalence on adolescent marijuana use in the context of the theory of planned behavior (TPB). With data from the National Survey of Parents and Youth (N = 1,604), two hierarchical multiple regression models were developed to examine the association of ambivalent attitudes, intentions, and later marijuana use. The first model explored the moderating effect of ambivalence on intentions to use marijuana; the second tested the moderation of ambivalence on actual marijuana use 1 year later. Results across both analyses suggest that ambivalence moderated the association of friend norms and subsequent adolescent marijuana use: friend norms were better predictors of marijuana intentions (ß = 0.151, t = 2.29, p = 0.02) and subsequent use when adolescents were attitudinally ambivalent about marijuana use (ß = 0.071, t = 2.76, p = 0.006). These results suggest that preventive programs that affect the certainty with which adolescents holds pro- or antimarijuana attitudes may influence the likelihood of their resistance to, initiation, or continuance of marijuana use.

Depression and help seeking among Mexican-Americans: the mediating role of familism.

Increased depression symptomatology results in a reduced willingness to seek help from family. Focusing on Mexican-Americans, the current study hypothesized that the a reduction in favorable perceptions of familial relations could be partially to blame for limited help seeking among people with depression. Data were collected from 84 Mexican-Americans. Measures assessed depression symptomatology, familism, perceptions of help seeking from family, and demographics. As predicted: (1) depression symptomatology was negatively associated with perceptions of help seeking from family; (2) familism was positively associated with perceptions of help seeking from family; and, (3) depression symptomatology was negatively associated with familism. Further, familism partially mediated the relationship between depression symptomatology and help seeking comfort, as well as between depression symptomatology and the perceived utility of familial help seeking. The results indicate a reduction in familistic values may be partially responsible for reduced help seeking among Mexican-Americans with depression.

Adolescents' attitudes toward antimarijuana ads, usage intentions, and actual marijuana usage.

The association of adolescents' appraisals of the antimarijuana TV ads used in the National Youth Antidrug Media Campaign with future marijuana use was investigated. The 12- to 18-year-old respondents (N = 2,993) were first classified as users, resolute nonusers, or vulnerable nonusers (Crano, Siegel, Alvaro, Lac, & Hemovich, 2008). Usage status and the covariates of gender, age, and attitudes toward marijuana were used to predict attitudes toward the ads (Aad) in the first phase of a multilevel linear analysis. All covariates were significantly associated with Aad, as was usage status: Resolute nonusers evaluated the ads significantly more positively than vulnerable nonusers and users (all ps < .001), who did not differ. In the second phase, the covariates along with Aad and respondents' usage status predicted intentions and actual usage 1 year after initial measurement. The lagged analysis disclosed negative associations between Aad and usage intentions and between Aad and actual marijuana use (both ps < .05); however, this association held only for users (p < .01), not vulnerable or resolute nonusers. Users who reported more positive attitudes toward the ads were less likely to report intention to use marijuana and to continue marijuana use at 1-year follow-up. These findings may inform designers of persuasion-based prevention campaigns, guiding preimplementation efforts in the design of ads that targeted groups find appealing and thus, influential.

The effect of depression on physician-patient communication among Hispanic end-stage renal disease patients.

End-stage renal disease is associated with increased level of depression. Depression is associated with a reduction in the ability of people to effectively communicate in interpersonal settings. The interaction between end-stage renal disease patients and their physicians has important implications for the course of the treatment of this disease; however, there is limited research examining the influence of depression on general patient-physician communication. This study examines the association between depression and physician-patient communication in a sample of Hispanic end-stage renal disease patients. Participating patients filled out the Beck Depression Inventory and self-reported their feelings about meeting with physicians. Patients then met with a physician, and a nurse practitioner observed the interaction. Results indicate that depression was negatively associated with patients' self-reported perceptions of their readiness for the appointment (r =-.20) and with self-reported communication efficacy (r =-.19). Moreover, the nurse practitioner rated patients with depression as being significantly less likely (a) to ask for clarification (r =-.40), (b) to be engaged in the conversation (r =-.46), and (c) to be forthcoming with the physician (r =-.37). Results of this study have significant implications for communication between physicians and end-stage renal disease patients and for the influence of depression on patient-physician communication.

Attachment theory and theory of planned behavior: an integrative model predicting underage drinking.

Research indicates that peer and maternal bonds play important but sometimes contrasting roles in the outcomes of children. Less is known about attachment bonds to these 2 reference groups in young adults. Using a sample of 351 participants (18 to 20 years of age), the research integrated two theoretical traditions: attachment theory and theory of planned behavior (TPB). The predictive contribution of both theories was examined in the context of underage adult alcohol use. Using full structural equation modeling, results substantiated the hypotheses that secure peer attachment positively predicted norms and behavioral control toward alcohol, but secure maternal attachment inversely predicted attitudes and behavioral control toward alcohol. Alcohol attitudes, norms, and behavioral control each uniquely explained alcohol intentions, which anticipated an increase in alcohol behavior 1 month later. The hypothesized processes were statistically corroborated by tests of indirect and total effects. These findings support recommendations for programs designed to curtail risky levels of underage drinking using the tenets of attachment theory and TPB.

Increasing social support for depressed individuals: a cross-cultural assessment of an affect-expectancy approach.

Depression is a mental illness affecting 121 million people. The Substance Abuse and Mental Health Services Administration recently launched a national, bilingual (English and Spanish) campaign to motivate young adults to support friends with mental illness. This article highlights and assesses the usefulness of two theoretically derived variables for increasing the social support received by all depressed individuals: (a) affect and (b) social support outcome expectations. In accord with the Substance Abuse and Mental Health Services Administration's bilingual campaign, the authors conducted two studies using intercepts at 2 swap meets in the U.S. Southwest. One study sample consisted of Spanish-dominant Hispanics, the other non-Hispanics. For both samples, results indicate that affect, social support outcome expectations, and their interaction accounted for more than 50% of the variance of social support intentions (67% in the Hispanic sample when familism was considered). Affect is commonplace in the helping behavior literature; results indicate social support outcome expectations deserve equal consideration. Moreover, an unexpected finding emerged: Perceiving a lack of willpower, need for attention, and lack of moral character to be the cause of depression resulted in increased sympathy among the Hispanic sample but increased anger among non-Hispanics.

"Can you spare an organ?": exploring Hispanic Americans' willingness to discuss living organ donation with loved ones.

Living organ donation offers a means of overcoming the shortage of viable organs available for transplant: a shortage particularly problematic among Hispanics. One barrier standing between those in need of a kidney and a successful transplant operation is an inability, and often lack of desire, to talk to loved ones about the need for a living donation. With an eye on future intervention approaches, and guided in part by the theory of planned behavior, this research effort sought to explore the factors associated with a willingness to engage in a conversation about a living donation with loved ones. Study 1, a phone survey of Hispanic Americans drawn from a Hispanic surname list, reveals that while upward of 90% of respondents would be willing to offer a kidney to a family member in need, and a similar percentage would be willing to accept a living donation if offered, only about half of respondents would feel comfortable initiating a conversation with family members if the respondent was in need of a living donation. Study 2, a survey of Hispanic American patients currently in need of a living kidney donation, revealed that perceived behavioral control accounted for 60% of the variance in future intentions to initiate a conversation among those who have yet to speak to a family member about becoming a living donor. Moreover, perceived behavioral control mediated the relationship between perceived asking appropriateness and future intentions to initiate a conversation. Lastly, recipient outcome expectations, asking appropriateness, and subjective norms were revealed to be predictive of perceived behavioral control. Implications for future living donor interventions focusing on increasing recipient-initiated conversations are discussed.

Increasing organ donor registration rates by providing an immediate and complete registration opportunity: an experimental assessment of the IIFF model.

The IIFF model of organ donation holds that the simultaneous presence of four factors directly influence donor registration: (1) immediate and complete registration opportunity (ICRO), (2) information, (3) focused engagement, and (4) favorable activation. Two field experiments examined the impact of an ICRO on organ donation registration. In Study 1, participants were at town halls where they knew organ donation was to be discussed. Registration cards were distributed and then collected at the end of the session in half of the town halls. For the other half, participants were asked to mail in completed cards. In three US cities, participants given an ICRO registered at a significantly greater rate (z = 4.865, p < 0.05). Study 2, targeting Hispanics at a swap meet, differed in that the registration impact of awareness of the availability of an ICRO was investigated. Participants made aware of an ICRO registered at a significantly greater rate (z = 4.1, p = 0.000).