Overconfidence in Managing Health Concerns: The Dunning-Kruger Effect and Health Literacy.

Health literacy is often low within the general population. The Dunning-Kruger effect (DKE) suggests that individuals may experience a cognitive bias in which they overestimate their own knowledge base. This study examines the DKE regarding health literacy and health behaviors. A community sample (n = 504) completed questionnaires measuring objective health literacy, confidence in health knowledge, and health behaviors and medical conditions. Results support the presence of a DKE for health literacy; individuals with low health literacy reported equal or greater confidence in health knowledge than individuals with higher health literacy. Individuals with lower health literacy reported more problematic engagement in health behaviors. Low health literacy can impact engagement in health behavior and effect health outcomes, but individuals may not realize this deficit. Implications for clinical intervention include the need to address cognitive bias and enhance motivation to participate in health literacy interventions.

Health Care Decisions and Delay of Treatment in Companion Animal Owners.

Previous research has indicated that companion animal ownership may confer health benefits; however, no studies have considered how companion animal ownership impacts key health decisions. The purpose of the current studies was to examine the extent to which animal-related factors influence health care decision making, specifically, owners' willingness to proceed with necessary medical treatments. In Study 1, a sample of 162 companion animal owners was recruited via Amazon Mechanical Turk to complete an online survey which included measures of social support, quality of relationship with the companion animal and two vignettes describing needed hospitalization. Results suggest that nearly half of companion animal owners would consider delaying a hospitalization due to reasons related to ownership. Similarly, in Study 2, dog owners were compared to a group of non-pet owners. Dog owners were more likely to report willingness to delay medical procedures due to their pets than non-pet owners were to consider delay due to friends or family members. Owners' health care decisions may be influenced by their relationship with their companion animal. Particularly at risk for delaying health procedures are those with lower levels of social support. While further study is needed, opportunities for intervention are considered.

A proximal change experiment testing two communication exercises with intimate partner violent men.

This study tests the immediate impact of two interventions for intimate partner violent (IPV) men in affecting behavioral and emotional change during arguments with their partners. Couples with an abusive male partner (N=100) discussed an area of conflict twice, interrupted by a brief intervention. Men were randomly assigned to receive (a) an editing-out-the-negative skills training, (b) an accepting influence skills training, or (c) a time-out. IPV men in both skills-training conditions showed greater decreases in aggressive feelings than IPV men in the time-out condition based on their self-report and observed affective behavior. Women also reported feeling less aggressive when their husbands were assigned to one of the skills-training conditions as compared to the control (time-out) condition. Results suggest that IPV men can learn to adopt new communication skills and that they do appear to have a positive impact on the emotional tone of their arguments. Clinically, communication skills training may be a useful addition to battering intervention programs, although these skills may need to be taught to both men and women involved in violent relationships.

Physical and psychological abuse in breast cancer survivors and cancer-free women.

The purpose of this study was to provide a preliminary examination of intimate partner abuse in survivors of breast cancer relative to women who have never been diagnosed with cancer. The current study retrospectively evaluated the presence of physical or severe psychological abuse before cancer diagnosis, during treatment, and after remission of cancer in a sample of 206 ethnically diverse breast cancer survivors and 206 age- and ethnicity-matched control participants. Breast cancer survivors were less likely than controls to report abuse and did not report significant changes in frequency of abuse after cancer diagnosis or treatment.

Meta-analysis of EEG biofeedback in treating epilepsy.

About one third of patients with epilepsy do not benefit from medical treatment. For these patients electroencephalographic (EEG) biofeedback is a viable alternative. EEG biofeedback, or neurofeedback, normalizes or enhances EEG activity by means of operant conditioning. While dozens of scientific reports have been published on neurofeedback for seizure disorder, most have been case series with too few subjects to establish efficacy. The purpose of this paper is to meta-analyze existing research on neurofeedback and epilepsy. We analyzed every EEG biofeedback study indexed in MedLine, PsychInfo, and PsychLit databases between 1970 and 2005 on epilepsy that provided seizure frequency change in response to feedback. Sixty-three studies have been published, 10 of which provided enough outcome information to be included in a meta-analysis. All studies consisted of patients whose seizures were not controlled by medical therapies, which is a very important factor to keep in mind when interpreting the results. Nine of 10 studies reinforced sensorimotor rhythms (SMR) while 1 study trained slow cortical potentials (SCP). All studies reported an overall mean decreased seizure incidence following treatment and 64 out of 87 patients (74%) reported fewer weekly seizures in response to EEG biofeedback. Treatment effect was mean log (post/pre) where pre and post represent number of seizures per week prior to treatment and at final evaluation, respectively. Due to prevalence of small groups, Hedges's g was computed for effect size. As sample heterogeneity was possible (Q test, p=.18), random effects were assumed and the effect of intervention was -0.233, SE = 0.057, z = -4.11, p<.001. Based on this meta-analysis, EEG operant conditioning was found to produce a significant reduction on seizure frequency. This finding is especially noteworthy given the patient group, individuals who had been unable to control their seizures with medical treatment.

Preliminary report on the Accountability Scale: a change and outcome measure for intimate partner violence research.

The current study investigated the reliability of a new self-report questionnaire assessing accountability for the perpetration of intimate partner violence. The Accountability Scale (AS) is a brief, Likert-type measure designed to assess the degree to which perpetrators acknowledge and accept responsibility for their violent actions. In Study #1, an exploratory factor analysis on a clinical sample revealed two factors: Acknowledging Harm and Internalizing Responsibility. In Study #2, the factor structure was replicated on a community sample using confirmatory factor analysis, revealing an 11-item solution. Factor 1 was related to readiness to change but negatively related to social desirability, suggesting convergent and discriminant validity of that subscale. Factor 2 was negatively related to Factor 1 in the community sample, calling into question the construct of accountability. Preliminary evidence suggests that the AS shows promise as a brief and reliable tool to assess forms of accountability. Future research will examine if the two factors of accountability function as mechanisms of change and outcome measures in intimate partner violence intervention research.

Applying the transtheoretical model to female and male perpetrators of intimate partner violence: gender differences in stages and processes of change.

The Transtheoretical Model has been recently applied to men seeking services at battering intervention and prevention programs (Eckhardt, Babcock, & Homack, 2004; Murphy & Baxter, 1997). This study considers whether women arrested for intimate partner violence differ from male perpetrators in terms of stages of change and processes of change. No gender differences were found regarding stage of change. In general, all individuals presenting for treatment were in the early stages of change. The use of various processes of change was strongly related to stage of change, with individuals in the more advanced stages of change using more behavioral and experiential strategies to become nonviolent. However, except for the use of social liberation strategies, there were no gender differences in the use of the various processes. These findings suggest that the Transtheoretical Model may apply to female perpetrators equally as well as to male perpetrators. Intervention programs designed for male batterers using the Transtheoretical Model may also be helpful in the treatment of women arrested for domestic violence.

Management of terminal illness: a medical school-hospice partnership model to teach medical students about end-of-life care.

Physicians are not only called upon to deal with biological, but also with psychosocial issues and concerns in the treatment of the terminally ill. Their training, however, usually does not prepare them to value palliative care, or help them cope with personal feelings about death and possible grief over a patient's loss. The authors describe what one medical school is doing regarding the challenge of preparing medical students to deal more competently and confidently with end-of-life scenarios they will encounter as primary care practitioners in underserved areas of a rural state.