Het effect van sociale vergelijkingsinformatie op de levenssatisfactie van fragiele ouderen.

Social comparison is increasingly recognized as an important cognitive process in adaptation to old age. By comparing themselves with age peers who are doing worse, i.e., downward comparison, older persons can make an adjusted assessment that allows them to reinterpret their present lives in a positive manner. "Even though I can no longer do my own shopping, I'm still fortunate compared to those who can not leave their houses at all". In this way, older persons may preserve a certain level of life satisfaction, despite age-related loss. In a study among 455 community-dwelling older persons, the effects of social comparison on life satisfaction were examined. Older persons were confronted with a fictitious interview with either an upward or a downward target. After downward comparison, older persons felt more satisfied with their lives than after upward comparison, especially those who had higher levels of frailty. These effects were only found with lower levels of identification. With higher levels of identification, older persons felt more satisfied with their lives after upward comparison than after downward comparison. Apparently, downward comparison only serves its self-enhancing function on life satisfaction among frail elderly persons when they perceive the comparison target as different from themselves.

Rationalizations and defensive attributions for high-risk sex among heterosexuals.

A group of 39 respondents high at risk for HIV and a group of 39 respondents low at risk for HIV were selected from a larger sample to examine their rationalizations and attributions for having unprotected sex. Respondents high at risk for HIV used more often rationalizations and attributions to justify and excuse their risky behavior. At the same time, respondents high at risk were somewhat more fearful of contracting Acquired Immune Deficiency Syndrome (AIDS), and did not deny the riskiness of their behaviors compared with low-risk respondents. It is suggested that interventions should not focus on enhancing risk perceptions, but rather on challenging rationalizations and attributions that foster risky sexual behavior.

Neuroticism and social comparison orientation as moderators of affective responses to social comparison at work.

In a study among 72 nurses, the affective consequences of social comparison were examined and related to neuroticism (N) and to social comparison orientation (SCO). Participants were confronted with a bogus interview with an upward versus a downward comparison target. Positive affect and identification were higher, and negative affect was lower, in the upward than in the downward comparison condition. Independent of their SCO, the higher individuals were in N, the less they identified with the upward comparison target, the more they identified with the downward comparison target, and the less positive affect they showed following confrontation with the upward comparison target. In contrast, independent of their level of N, the higher individuals were in SCO, the more negative affect they showed following confrontation with the downward comparison target. The effects on negative affect stayed the same when controlling for positive affect, and the effects on positive affect stayed the same when controlling for negative affect. These effects were also obtained when perceived direction was used as a predictor instead of the experimentally manipulated direction. It is concluded that, although N and SCO are correlated, these variables seem to have independent and distinct effects upon the responses to social comparison information.

Burnout and inequity among human service professionals: a longitudinal study.

In a composite sample of human service professionals (N = 245), longitudinal relations across 1 year were tested between equity in the professional-recipient relationship and burnout (i.e., emotional exhaustion, depersonalization, and reduced personal accomplishment). The 1st research question was whether inequity influenced burnout across time. The 2nd research question was whether longitudinal relations between equity and burnout were curvilinear, as predicted by equity theory. The results confirmed that inequity affects the central component of burnout (i.e., emotional exhaustion) and that this relation is curvilinear. Feeling more deprived and feeling more advantaged resulted in higher future emotional exhaustion levels. No indication was found for a longitudinal relation between inequity and depersonalization. A synchronous relation was found suggesting that personal accomplishment influences equity.

Perceived superiority of one's own relationship and perceived prevalence of happy and unhappy relationships.

In a study among 141 Dutch undergraduate students, the participants perceived their relationship on average as better than the relationships of most others, and assumed that a majority was happy and that only a minority was unhappy with their relationship. The higher the relationship satisfaction, the more one considered one's relationship as superior, the higher one estimated the percentage of individuals happy with their relationship, and the lower one estimated the percentage of individuals unhappy with their relationship. Overall, these three perceptions were independently related to relationship satisfaction. However, men's satisfaction was particularly related to the perception that one's own relationship was superior as well as to the assumption that few others were unhappy with their relationship, whereas women's satisfaction was particularly related to the assumption that most others were happy with their relationship.

Can public campaigns effectively change psychological determinants of safer sex? An evaluation of three Dutch campaigns.

This study evaluated the 1994, 1995 and 1996 Dutch safer sex campaigns as to their effectiveness in terms of improved attitudes, perceived social norms, self-efficacy and intentions regarding safer sex. The hypotheses were tested that variables become more positive when campaigns are conducted and less positive when campaigns are discontinued. A comprehensive design, including a baseline-post-test/post-test-only group design and a longitudinal or multiple assessment group design, was employed to exclude testing effects, history effects, cultural changes and sample differences as alternative explanations. The results show that despite high baseline levels, the campaigns positively affected all variables. Importantly, levels of all variables decreased when no campaign was conducted. It is concluded that campaigns are needed to maintain high levels of determinants of safer sex and that future campaign goals should be formulated in terms of stabilization instead of growth.

Marital satisfaction in patients with cancer: does support from intimate partners benefit those who need it the most?

This cross-sectional study assessed 3 ways of providing spousal support. Active engagement means involving the patient in discussions and using constructive problem-solving methods; protective buffering means hiding one's concerns; and overprotection refers to underestimation of the patient's capabilities, resulting in unnecessary help and excessive praise for accomplishments. Ratings of received spousal support by 68 patients with cancer revealed findings similar to those of partners' ratings of provided support. The positive association between active engagement and the patient's marital satisfaction was stronger for patients with a rather poor psychological and physical condition than for those with a rather good condition. Furthermore, protective buffering and overprotection were negatively associated with marital satisfaction only when patients experienced relatively high levels of psychological distress or physical limitations.

Couples dealing with cancer: role and gender differences regarding psychological distress and quality of life.

The goal of the present study was to further knowledge on gender and role (i.e. patient versus partner) differences in psychological distress and quality of life as a consequence of dealing with cancer. There is some evidence that being the patient or the caregiver makes more difference for men than for women. In total, 173 couples facing various forms of cancer (two samples) and a control group of 80 couples completed the CES-D and Cantril's Ladder. Analyses of variance revealed that both female patients and female partners of patients perceived more psychological distress and a lower quality of life than women in healthy couples. In contrast, role did have an effect on men. Specifically, male patients scored as high on psychological distress and as low on quality of life as female patients and female partners, but psychological distress and quality of life did not differ between male partners of patients and their healthy controls. However, this effect was found in only one patient sample. The finding that female partners perceived more psychological distress and a lower quality of life than male partners could not be accounted for by differences in the physical condition of the patient or the partner.

Comparison of 50-mg and 100-mg sustained-release isosorbide mononitrate in the treatment of stable angina pectoris: effects on quality-of-life indices. Dutch Mononitrate Quality of Life (DUMQOL) Study Group.

High-dosage nitrates are more effective for the management of anginal symptoms but produce more adverse effects, including development of tolerance and the zero-hour effect (rebound angina at the end of the dosing interval). Such effects may reduce the beneficial effect of treatment on quality of life. In a self-controlled, 6-month study, the effects on symptoms and quality of life of 50 mg and 100 mg sustained-release isosorbide mononitrate (SR ISMN), administered once daily, on anginal symptoms and quality of life (QOL) were assessed in 453 patients with stable angina pectoris. QOL was assessed by means of a test battery based on the Medical Outcomes Short-Form 36 Health Survey and the Angina Pectoris Quality of Life Questionnaire. The internal consistency and reliability of the multiitem scales were estimated by use of Cronbach's alpha coefficient. Based on their improvements in New York Heart Association (NYHA) angina classification, patients who received 100 mg daily showed greater improvement than those who received 50 mgdaily; the mean difference between treatments was consistent with a significantly greater improvement of mobility and angina indices. Adverse effects, as estimated by side-effect index, including rebound angina at times of rest, and by patient compliance rating, differed slightly between the two treatment regimens and were even less problematic with the higher dosage than with the lower dosage. Psychological distress index and life satisfaction scores also were significantly higher with 100 mg than with 50 mg daily. The results of this study suggest that SR ISMN 100 mg once daily provided a better NYHA angina classification than SR ISMN 50 mg did and did not produce further adverse effects. In addition SR ISMN 100 mg improved various QOL indices more than SR ISMN 50 mg did, particularly the mobility index and certain life satisfaction scores, which are the most important indicators of QOL in this category of patients.

Effect of high- versus low-frequency exercise training in multidisciplinary cardiac rehabilitation on health-related quality of life.

BACKGROUND: The authors examined the importance of the frequency of aerobic exercise training in multidisciplinary rehabilitation in improving health-related quality of life in the short run in patients with documented coronary artery disease. METHODS: Patients (114 males and 16 females; age range, 32-70 years) were randomized into either a high-frequency or a low-frequency exercise training program (10 versus 2 sessions per week, respectively) as part of a 6-week multidisciplinary cardiac rehabilitation program. The General Health Questionnaire and the RAND-36 were used to assess changes in psychological distress and subjective health status. RESULTS: After 6 weeks, high-frequency patients reported significantly more positive, change in "psychological distress" (P < 0.05), "mental health" (P = 0.05), and "health change" (P < 0.01), than low-frequency patients. Apart from changes in mean scores, individual effect sizes indicated that a significantly greater percentage of high-frequency patients experienced substantial improvements in "psychological distress" (P < 0.01), "physical functioning" (P < 0.05), and "health change" (P < 0.05), compared with low-frequency patients. In addition, deterioration of quality of life was observed in a considerable number of high-frequency patients (ranging from 1.7% to 25.8% on the various measures). CONCLUSIONS: The frequency of aerobic exercise has a positive, independent effect on psychological outcomes after cardiac rehabilitation. However, this benefit after high-frequency rehabilitation appears to be limited to a subgroup of patients. Further investigation is required to identify these patients. Results provide input into recent controversies regarding the role of exercise training in cardiac rehabilitation.

Individual differences in social comparison: development of a scale of social comparison orientation.

Development and validation of a measure of individual differences in social comparison orientation (the Iowa-Netherlands Comparison Orientation Measure [INCOM]) are described. Assuming that the tendency toward social comparison is universal, the scale was constructed so as to be appropriate to and comparable in 2 cultures: American and Dutch. It was then administered to several thousand people in each country. Analyses of these data are presented indicating that the scale has good psychometric properties. In addition, a laboratory study and several field studies are described that demonstrated the INCOM's ability to predict comparison behavior effectively. Possible uses of the scale in basic and applied settings are discussed.

Change in self-efficacy during cardiac rehabilitation and the role of perceived overprotectiveness.

Self-efficacy (SE) is an important outcome following cardiac rehabilitation (CR) when claiming benefits to patients and improving existing programs. This study evaluated change in SE during 6 weeks of multidisciplinary CR with either a high or low-frequency exercise training program. The role of overprotectiveness of the spouse, as it potentially counteracts improvement in SE, was examined. Coronary patients (n = 114) were randomized into both types of program. Overprotectiveness (patient perception) was assessed prior to rehabilitation. Self-efficacy in the domains controlling symptoms (SE-CS) and maintaining function (SE-MF), were assessed prior to and immediately after rehabilitation. Three findings pertain to program improvement: (1) As predicted, the low-frequency program enhanced SE-CS more than the high-frequency program, suggesting that experiencing success in daily activities and active engagement of the patient seem more decisive factors in improving SE than the frequency of exercise. (2) Changes in SE in both programs fell short of clinical meaning, suggesting the need to use self-efficacy theory more vigorously. (3) Overprotectiveness significantly predicted adverse change in SE in the high-frequency program, suggesting the need to include counseling for cardiac couples in CR when applicable.

Social loafing under fatigue.

In 2 experiments, 64 male students worked almost continuously for 20 hr without sleep under varying social conditions. In Experiment 1, participants worked either individually or as a group. As hypothesized, performance deteriorated over time, especially in the group condition, which allowed participants to loaf. In Experiment 2, all participants worked in groups. They were instructed that public feedback would be provided either on the group result only or on the individual results of all group members. As expected, when individual results were made public, performance deteriorated less. Overall, the data suggest that fatigue increases social loafing. However, both individualizing the task and providing public individual feedback seem to counteract these effects.

Social comparison preferences among cancer patients as related to neuroticism and social comparison orientation.

Effects of neuroticism and social comparison orientation on social comparison among cancer patients were examined. A computer program that enabled patients to access information about fellow patients' disease-related experiences was developed. Patients selected more interviews concerning more as compared to less fortunate others, spent more time reading, and showed more favorable reactions to such information. Individuals with a strong comparison orientation in particular tended to engage in and to respond to social comparison. Neuroticism was associated with higher interest in social comparison and with less favorable reactions, regardless of its direction. High-neurotic individuals reacted more positively to upward than to downward comparisons, whereas the reactions of low-neurotic individuals were unaffected by comparison direction. The latter effect was replicated using a general affect measure, but solely among individuals with a strong comparison orientation.

Predictors of AIDS-preventive behavioral intentions among adult heterosexuals at risk for HIV-infection: extending current models and measures.

This study examined the predictors of the intention to use condoms with new sexual partners. A sample of heterosexual adult females and males (n = 711) was recruited through various channels. A substantial part of the sample had engaged in risky sexual behavior. Predictors were based on various theoretical models. Compared with men, women were in general more aware of the risks of AIDS and perceived fewer barriers to using condoms, but they also perceived less support for condom use among potential new partners. Among those with a risk factor for HIV infection (n = 514), various types of barriers, absolute and comparative self-efficacy, and three types of social norms were independently related to the intention to use condoms. When including all relevant predictors, self-efficacy, anticipated regret, and descriptive norms in the reference group, were independent predictors of condom use intention among men as well as among women. The implications for prevention are discussed.

An exploration of the relation between hostility and disease.

Hostility has been studied mainly in relation to coronary heart disease (CHD). However, given the pathways linking hostility to CHD, it might be expected that hostility also relates to non-CHD. Therefore, the relation between the expression and the experience of hostility and various health outcomes was examined in a cross-sectional design. The data were collected among male patients with a myocardial infarction in the age range of 30-70 years (N = 279) and a population sample of men in the same age group (N = 2663). Based on checklist of the most frequent disorders, the subjects from the latter group were divided into subsamples according to their disease status. Three components of hostility, i.e., resentment, suspicion, and aggression, were measured by the Buss Durkee Hostility Inventory (Buss & Durkee, 1957). The overall finding was that all components of hostility were related to non-CHD disease but not to CHD.

Affective responses to social comparison: a study among disabled individuals.

The present study examined the effects of social comparison among 112 individuals receiving payments under the Disablement Insurance Act. A part of a fictitious interview with another disabled person was presented to the subjects. This interview contained upward or downward social comparison information about either the problem severity or coping success of a target. In line with the predictions, the results indicated that upward comparison generated more positive affect than downward comparison only for subjects high in perceived control. Downward comparison generated more negative affect than upward comparison, regardless of perceived control. The nature of the comparison dimension (problem severity versus coping success) did not result in differences in positive or negative affect. Furthermore, subjects high in control identified more strongly with the upward target than with the downward target, especially when the comparison dimension was coping success. Some evidence was found that the effect of perceived control on the positive affective consequences of upward comparison was mediated by identification with the upward target.

Social comparison as a mediator between health problems and subjective health evaluations.

The role of social comparison in mediating the relation between 'objective' health status and subjective health evaluations was examined. In a random population sample (N = 361) it was shown that health problems were related to psychological distress, which in turn induced a downward comparison process. This downward comparison resulted in a perception of being better off than others in a similar situation (relative evaluation). While both health problems and psychological distress had strong direct effects on general health evaluations, relative evaluations explained further significant variance. In addition, it was found that although women reported more psychological and physical problems than men, they engaged more often in downward comparison and consistently felt more than men did that their health was better than that of most others. No gender differences in general health evaluations were found. Interestingly, social comparison had a stronger impact on the general subjective well-being of women than of men.

[Condom use among heterosexuals: a comparison of the theory of planned behavior, the health belief model and protection motivation theory]. / Condoomgebruik door heteroseksuelen. Een vergelijking van de theorie van gepland gedrag, het health belief model en de protectie-motivatie theorie.

PIP: In the Netherlands, the theory of planned behavior (Ajzen, 1991), the health belief model (Janz and Becker, 1984), and the protection-motivation theory (Rogers, 1983) were compared for predicting condom use intentions because of AIDS. The 641 respondents were given two questionnaires: one for themselves and another one for a friend, partner, or acquaintance. 514 (80%) of them returned completed forms. 60% of these (307) persons were encouraged to answer and return another questionnaire, thus the final sample consisted of 821 responses. 711 individuals (481 women aged 15-91 years and 230 men aged 15-85 years) admitted having had heterosexual intercourse. 75% had had more than one sex partner in the previous 5 years. 45% had had sex at least once with someone other than their regular partner. Multivariance analysis of variance of promiscuity and condom use revealed that men exhibited more risky sex practices than women (p .001), had more sex partners in the previous 5 years than women (p .01), had more single sexual encounters with other persons than the regular sex partner than women (p .001), and they used condoms less often than women (p .01). 119 respondents had experienced sexually transmitted diseases and 165 had taken HIV tests. The difference between men and women also showed up in terms of their ideas, perceptions, and feelings about condom use when the three theoretical models were considered (p .001). The variables used in the theory of planned behavior explained the variance in intended condom use for 36% of women and 43% of men. The health belief model explained intended condom use only for 15% of women and 32% of men, while the cost-benefit analysis explained it for 9% of women and 18% of men. The protection-motivation theory explained intended condom use variance for 32% of women and 41% of men, but not all variables were included in the model. Fear from AIDS was correlated with inquisitive behavior and with seriousness (both p .001).^ieng

Social support and stress: the role of social comparison and social exchange processes.

This paper first presents four different conceptualizations of social support: social integration, satisfying relationships, perceived helpfulness and enacted support. Then, classic and contemporary social comparison theory and social exchange theory are analysed as they are two theoretical perspectives that are particularly useful in understanding social support. These perspectives are employed to explain three seemingly paradoxical phenomena in the domain of social support: (1) the fact that support sometimes has negative effects; (2) the fact that the occurrence of stress itself can sometimes decrease the availability of support resources; and (3) the phenomenon that people believe that they give more support than they receive, and that there is more support available for them than for others.