Publications by authors named "Anne Moyer"

64 Publications

Acculturation, Sun Tanning Behavior, and Tanning Attitudes Among Asian College Students in the Northeastern USA.

Int J Behav Med 2021 May 4. Epub 2021 May 4.

Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, 10022, USA.

Background: College students participate in high levels of tanning, a skin cancer risk behavior due to ultraviolet radiation exposure, yet little is known about Asian college students' behavior. This study examined the relationship between tanning attitudes, acculturation to the USA (cultural assimilation), and tanning behavior.

Method: An online survey was used to recruit 211 Asian college students in the northeastern USA (47.4% born outside of the USA) to respond to questions about recent tanning behavior, sun protection strategies, attitudes about tanning, and acculturation to the USA.

Results: Attitudes about tanning, particularly desire for a darker skin tone and social norms, along with acculturation to the USA, were predictive of intentional tanning. The sample reported high levels of sun protection, which was associated with low acculturation.

Conclusion: The significant role of acculturation in this study indicates that it may be a useful factor to include in future tanning intervention studies of relevant populations.
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http://dx.doi.org/10.1007/s12529-021-09993-xDOI Listing
May 2021

The Impact of Matching to Psychotherapy Preference on Engagement in a Randomized Controlled Trial for Patients With Advanced Cancer.

Front Psychol 2021 24;12:637519. Epub 2021 Feb 24.

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States.

This study examined whether patients who were randomly assigned to their preferred therapy arm had stronger engagement with their treatment than those who were randomly assigned to a non-preferred therapy arm. Data were drawn from a RCT comparing Individual Meaning-Centered Psychotherapy (IMCP), with Individual Supportive Psychotherapy (ISP), in patients with advanced cancer. Treatment engagement was operationalized as patients' perceptions of the therapeutic alliance with their therapist and therapy sessions attended. Two 2 by 2 Analysis of Variance (ANOVA) models were used, with treatment preference (IMCP vs. ISP) and treatment assignment (IMCP vs. ISP) as the independent variables and working alliance and number of sessions attended as outcome variables. Patients who preferred and were assigned to IMCP reported a significantly stronger alliance than those who preferred IMCP but were assigned to ISP. The findings from this study have broader implications for research on psychotherapy beyond the appeal of IMCP in advanced cancer patients. Patients who prefer a novel psychotherapy that they cannot engage in elsewhere, but receive the standard treatment may experience weaker alliance than patients who prefer the standard but receive the novel therapy. Clinicaltrial.gov ID: NCT01323309.
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http://dx.doi.org/10.3389/fpsyg.2021.637519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959844PMC
February 2021

Young adults' stigmatizing perceptions about individuals with skin cancer: the influence of potential cancer cause, cancer metaphors, and gender.

Psychol Health 2021 Jan 6:1-18. Epub 2021 Jan 6.

Department of Psychology, Stony Brook University, Stony Brook, New York, USA.

This study examined the influence of three potential predictors of stigmatising cancer perceptions: the controllability of the cancer cause, metaphors used to describe the cancer experience, and the target's gender. 306 undergraduates (age = 20) were recruited via subject pool, balancing males and females. Participants read a fictitious post by a patient/blogger with skin cancer that described different potential causes for their cancer varying with respect to its controllability, used varying types of commonly invoked cancer metaphors, and indicated their gender with names. Potential stigmatisation of the blogger in the form of negative affective responses, perceptions of flawed character, desired social distance and expectations for post-traumatic growth were assessed using mixed methods. The perceived age of the blogger and expectations for their survival were also explored. More blame, less sympathy, and less favourable perceptions of character were ascribed to the hypothetical blogger when their cancer was described as due to their lifestyle rather than genetics and thus potentially construed as more controllable. Females using a war metaphor resulted in more positive responses compared to a female using no metaphorical language. Stigmatisation of individuals with skin cancer may depend on the potential cause of cancer, and to some extent, metaphors and gender.
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http://dx.doi.org/10.1080/08870446.2020.1869738DOI Listing
January 2021

The relationship between post-traumatic stress and post-traumatic growth in cancer patients and survivors: A systematic review and meta-analysis.

Psychooncology 2020 04 14;29(4):604-616. Epub 2020 Jan 14.

Department of Psychology, Stony Brook University, Stony Brook, New York.

Objective: Research on the relationship between post-traumatic stress disorder (PTSD)/post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in cancer patients and survivors is increasing.

Methods: We conducted a systematic review and meta-analysis of 51 studies that assessed the relationship between PTSD/PTSS and PTG, in cancer patients/survivors. Five databases were searched through 29 April 2019. The purpose of this manuscript is to report a summary of this literature, the aggregate effect size of the relationship between PTSD and PTG, and the examination of potential moderators that may impact the relationship between PTSD and PTG.

Results: The aggregate weighted effect size for the association between PTSD/PTSS and PTG was small, r = .08, but significantly different from zero. We examined whether time since diagnosis, stage of cancer, type of measure used to assess PTSD/PTSS, or type of measure used to assess PTG explained the significant heterogeneity among the individual effect sizes. The relationship was significantly stronger for the small subset of studies that included only stage 4 patients compared with those that included only non-stage 4 patients. Additionally, the strongest relationship was for those studies that used the Impact of Events Scale-Revised to assess PTSD.

Conclusions: The relationship between PTSD/PTSD and PTG is modestly positive and robust. There is evidence that the threat of advanced cancer is more strongly associated with growth, but none supporting that more time since cancer diagnosis allows survivors the opportunity to positively reinterpret and find meaning in the traumatic aspects of the disease resulting in more growth.
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http://dx.doi.org/10.1002/pon.5314DOI Listing
April 2020

Adolescent sleep and technology-use rules: results from the California Health Interview Survey.

Sleep Health 2020 02 13;6(1):19-22. Epub 2019 Nov 13.

Stony Brook University.

Objectives: This study reports on adolescent sleep, technology-use rules at home, and their potential association using the 2017 California Health Interview Survey (CHIS).

Methods: CHIS cross-sectional, representative survey data was collected between June-December 2017 via telephone. Weekday bedtimes, rise times, and night time in bed in the past week, as well as whether technology-use rules were implemented at home, were examined among 448 adolescent residents of California (mean age = 14.5, range = 12-17; 48% women).

Results: The average weekday nightly time in bed was 9.04 hours among 12- to 13-year-olds and 7.89 hours among 14- to 17-year-olds. The majority reported having technology-use rules and those who did, spent 35 more minutes in bed. Although a significant relationship was found between having technology-use rules and earlier bedtime, one was not found for time in bed, when controlling for demographics.

Conclusions: Many California adolescents do not meet recommended sleep guidelines. Yet, technology-use rules appear to be associated with earlier bedtime. Results have implications for policy-making and adolescent sleep interventions.
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http://dx.doi.org/10.1016/j.sleh.2019.08.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7346706PMC
February 2020

Barriers to mammography screening among racial and ethnic minority women.

Soc Sci Med 2019 10 20;239:112494. Epub 2019 Aug 20.

Stony Brook University, USA. Electronic address:

Rationale: Breast cancer is the second leading cause of cancer death among women. Disparities in breast cancer mortality rates adversely affect racial/ethnic minority women. Mammography screening is the most effective early detection method and means of reducing mortality rates. Yet, barriers prevent racial/ethnic minority women from participating in regular screening.

Objective: This review aimed to summarize self-reported barriers to mammography screening in racial/ethnic minority women in studies using open-ended assessments and closed-ended assessments.

Method: Literature searches were conducted in two databases, PsycINFO and PubMed. Barriers were detailed in full by barrier type (psychological/knowledge-related, logistical, cultural/immigration-related, and social/interpersonal) and summarized briefly by race/ethnicity (African American/Black, Asian/Pacific Islander, Hispanic, American Indian/Native American, and Middle Eastern).

Results: Twenty-two open-ended and six closed-ended studies were identified as eligible for this review. Overall, racial/ethnic minority women identified common logistical and psychological/knowledge-related barriers. Additionally, women reported cultural/immigration-related and social/interpersonal barriers that were closely tied to their racial/ethnic identities.

Conclusions: It was concluded that cultural/immigration-related barriers may be the only barrier type that is unique to racial/ethnic minority women. Thus, designing studies of barriers around race and ethnicity is not always appropriate, and other demographic factors are sometimes a more important focus. The variability in 'barrier' definitions, how data were collected and reported, and the appropriateness of closed-ended measures were also examined. This literature may benefit from detailed and strategically designed studies that allow more clear-cut conclusions and better comparison across studies as well as improving closed-ended measures by incorporating insights from investigations using open-ended inquiry.
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http://dx.doi.org/10.1016/j.socscimed.2019.112494DOI Listing
October 2019

Social Psychological Theories and Nudges as Tools for Health Promotion.

Am J Bioeth 2019 05;19(5):74-76

a Stony Brook University.

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http://dx.doi.org/10.1080/15265161.2019.1588417DOI Listing
May 2019

Is There a Spillover Effect of Targeted Dietary Change on Untargeted Health Behaviors? Evidence From a Dietary Modification Trial.

Health Educ Behav 2019 08 27;46(4):569-581. Epub 2019 Feb 27.

1 Stony Brook University, Stony Brook, NY, USA.

. The gateway behavior hypothesis posits that change in a health behavior targeted for modification may promote positive changes in other untargeted health behaviors; however, previous studies have shown inconsistent results. . To examine the patterns and predictors of change in untargeted health behaviors in a large health behavior change trial. . Using repeated-measures latent class analysis, this study explored patterns of change in untargeted physical activity, alcohol consumption, and smoking behavior during the first year of the Women's Health Initiative dietary modification trial that targeted total fat reduction to 20% kcal and targeted increased fruit and vegetable intake. Participants were healthy postmenopausal women who were randomly assigned to either the low-fat dietary change intervention ( = 8,193) or a control ( = 12,187) arm. . Although there were increases in untargeted physical activity and decreases in alcohol consumption and smoking in the first year, these changes were not consistently associated with study arm. Moreover, although the results of the repeated-measures latent class analysis identified three unique subgroups of participants with similar patterns of untargeted health behaviors, none of the subgroups showed substantial change in the probability of engagement in any of the behaviors over 1 year, and the study arms had nearly identical latent class solutions. . These findings suggest that the dietary intervention did not act as a gateway behavior for change in the untargeted behaviors and that researchers interested in changing multiple health behaviors may need to deliberately target additional behaviors.
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http://dx.doi.org/10.1177/1090198119831756DOI Listing
August 2019

Health intentions and behaviors of health app owners: a cross-sectional study.

Psychol Health Med 2019 08 7;24(7):819-826. Epub 2019 Feb 7.

a Department of Psychology , Stony Brook University , Stony Brook , USA.

Mobile devices have become widely popular in recent years. This popularity has been accompanied by the adoption of technologies created for those devices such as mobile applications (apps), many of which have been designed to facilitate achieving health goals. This study examined health-related intentions and behaviors, and their associations with mobile health app ownership in a large, nationally representative sample. Data from the Health Information National Trends Survey (HINTS) from the 2014 collection wave were analyzed. Expressing greater intentions to lose weight and to exercise was associated with owning mobile health apps. However, health app owners did not significantly differ from non-owners in their reported health behaviors in the domains of eating, exercise, and sedentary time. Although we do not know that the health apps that the app owners in this sample possessed were related to altering diet and exercise, this finding could suggest that health app owners do not use them, or that the ones available to them may be insufficient at eliciting and maintaining behaviors supporting relevant health intentions, suggesting an opportunity to leverage the capacities of mHealth technologies to produce more effective interventions delivered by apps informed by health behavior change theories.
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http://dx.doi.org/10.1080/13548506.2019.1576911DOI Listing
August 2019

'I am happier with my fairer complexion': factors associated with former indoor tanning and reasons for quitting in college women.

Psychol Health Med 2019 03 24;24(3):344-354. Epub 2018 Oct 24.

a Department of Psychology , Stony Brook University , Stony Brook , NY , USA.

This study of 312 female undergraduates investigated the association of recently, formerly, or never indoor tanning with self-perceptions and social influence, and examined reasons to tan and not to tan. Previous research on indoor tanning has focused on recent or current tanners, and few studies have examined former indoor tanners. By examining self-perceptions and social influence, this study aimed to understand how these common tanning correlates, measured in former indoor tanners, compared to those who have never tanned indoors (i.e., never tanners) and those who have recently tanned indoors. Appearance and global self-perceptions were more positive in former indoor tanners compared to never tanners and recent tanners. Recent indoor tanning was positively associated with both higher outdoor tanning frequency and having a higher number of friends performing skin cancer risk behaviors, and formerly indoor tanning was also associated with both, but to a lesser extent. Appearance and social influence were commonly described as reasons for indoor tanning, and perceived health risk, appearance, and social influence were described as prominent reasons for tanning cessation. This study improves what is known about former indoor tanners, which may be useful for behavior change maintenance efforts and developing approaches for skin cancer screening interventions.
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http://dx.doi.org/10.1080/13548506.2018.1537497DOI Listing
March 2019

Just relax and you'll get pregnant? Meta-analysis examining women's emotional distress and the outcome of assisted reproductive technology.

Soc Sci Med 2018 09 27;213:54-62. Epub 2018 Jun 27.

Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794-2500, USA. Electronic address:

Rationale: Couples worldwide are seeking treatment for infertility in growing numbers. Both infertility and its treatment are stressful experiences that generate considerable emotional distress. There is speculation that women's distress is associated with poorer likelihood of pregnancy via assisted reproductive technology (ART) and plausible psychobiological mechanisms bolster this association, although prior reviews of existing evidence find little support. A rigorous, comprehensive, and up to date analysis of research on the association of women's distress with ART outcomes is imperative.

Objective: We systematically searched for and analyzed evidence regarding the association of women's distress before and during treatment with the likelihood of treatment success via ART.

Method: Meta-analysis using a random-effects model was conducted on prospective studies (k = 20) that compared levels of anxiety, depressive symptoms, or perceived stress before or during ART treatment in women who achieved successful pregnancy outcomes versus those who did not (total N = 4308).

Results: Anxiety, depressive symptoms, or perceived stress pre-treatment, and anxiety or depressive symptoms during treatment, were not associated with less favorable ART outcomes. Prior treatment experience, age, and duration of infertility were not significant moderators of these associations. No eligible studies examined perceived stress during treatment.

Conclusion: Results cast doubt on the belief that distress impedes the success of infertility treatment, offering hope and optimism to the many women who feel emotionally responsible for the outcome of ART and informing the evidence-based practices of their health-care providers. We also identify specific areas and research methods needed to corroborate and extend study conclusions, including study of factors that elevate or attenuate distress in women undergoing infertility treatment.
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http://dx.doi.org/10.1016/j.socscimed.2018.06.033DOI Listing
September 2018

Psychological Aspects of Hoping for a Miracle.

Am J Bioeth 2018 05;18(5):67-68

a Stony Brook University.

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http://dx.doi.org/10.1080/15265161.2018.1431714DOI Listing
May 2018

The Extended Contact Hypothesis: A Meta-Analysis on 20 Years of Research.

Pers Soc Psychol Rev 2019 05 19;23(2):132-160. Epub 2018 Apr 19.

3 University of Oxford, England, UK.

According to the extended contact hypothesis, knowing that in-group members have cross-group friends improves attitudes toward this out-group. This meta-analysis covers the 20 years of research that currently exists on the extended contact hypothesis, and consists of 248 effect sizes from 115 studies. The aggregate relationship between extended contact and intergroup attitudes was r = .25, 95% confidence interval (CI) = [.22, .27], which reduced to r = .17, 95% CI = [.14, .19] after removing direct friendship's contribution; these results suggest that extended contact's hypothesized relationship to intergroup attitudes is small-to-medium and exists independently of direct friendship. This relationship was larger when extended contact was perceived versus actual, highlighting the importance of perception in extended contact. Current results on extended contact mostly resembled their direct friendship counterparts, suggesting similarity between these contact types. These unique insights about extended contact and its relationship with direct friendship should enrich and spur growth within this literature.
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http://dx.doi.org/10.1177/1088868318762647DOI Listing
May 2019

Psychosocial predictors of mammography history among Chinese American women without a recent mammogram.

Ethn Health 2020 08 5;25(6):862-873. Epub 2018 Mar 5.

Stony Brook University, Stony Brook, NY, USA.

Chinese American women have lower rates of mammography screening compared with non-Hispanic White women. Although the extent of perceived barriers, as conceptualized by the Health Belief Model, have been shown to distinguish between currently non-adherent Chinese American women who have ever and never had a mammogram, it is less clear which types of perceived barriers differentiate them. One hundred twenty-eight Chinese American women in the New York metropolitan area who had not had a mammogram in the past year completed baseline assessments for a mammography framing intervention study. Demographics, medical access variables, and perceived barriers to mammography (lack of access, lack of need for screening, and modesty) were used to predict mammography history (ever versus never screened). Fifty-five women (43%) reported having been screened at least once. A sequential logistic regression showed that English speaking ability and having health insurance significantly predicted mammography history. However, these control variables became non-significant when the three barrier factors were included in the final model. Women who reported a greater lack of access ( = 0.36,  < .05) and greater lack of need ( = 0.27,  < .01) were less likely to be ever screeners. Unexpectedly, women who reported greater modesty were more likely to be ever screeners ( = 4.78,  < .001). The results suggest that interventions for Chinese American women should identify and target specific perceived barriers with consideration of previous adherence.
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http://dx.doi.org/10.1080/13557858.2018.1447653DOI Listing
August 2020

Effects of school start time on students' sleep duration, daytime sleepiness, and attendance: a meta-analysis.

Sleep Health 2017 12 28;3(6):423-431. Epub 2017 Sep 28.

Stony Brook University.

Research conducted over the past three decades finds that many children and adolescents do not meet recommended sleep guidelines. Lack of sleep is a predictor of a number of consequences, including issues at school such as sleepiness and tardiness. Considering the severity of this public health issue, it is essential to understand more about the factors that may compromise children's and adolescents' sleep. This meta-analysis examined the effects of school start time (SST) on sleep duration of students by aggregating the results of five longitudinal studies and 15 cross-sectional comparison group studies. Results indicated that later starting school times are associated with longer sleep durations. Additionally, later start times were associated with less daytime sleepiness (7 studies) and tardiness to school (3 studies). However, methodological considerations, such as a need for more longitudinal primary research, lead to a cautious interpretation. Overall, this systematic analysis of SST studies suggests that delaying SST is associated with benefits for students' sleep and, thus, their general well-being.
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http://dx.doi.org/10.1016/j.sleh.2017.08.004DOI Listing
December 2017

How are non-numerical prognostic statements interpreted and are they subject to positive bias?

BMJ Support Palliat Care 2017 Dec 20;7(4). Epub 2017 Apr 20.

Department of Psychology, Stony Brook University, Stony Brook, New York, USA.

Objectives: Frank, clear communication with family members of terminally ill or incapacitated patients has important implications for well-being, satisfaction with care and sound decision-making. However, numerical prognostic statements, particularly more negative ones, have been found to be interpreted in a positively biased manner. Less precise non-numerical statements, preferred by physicians, and particularly statements using threatening terms (dying vs surviving) may be even more subject to such biases.

Methods: Participants (N=200) read non-numerical prognostic statements framed in terms of dying or surviving and indicated their interpretation of likelihood of survival.

Results: Even the most extreme statements were not interpreted to indicate 100% likelihood of surviving or dying, (eg, they will definitely survive, 92.77%). The poorness of prognoses was associated with more optimistically biased interpretations but this was not, however, affected by the wording of the prognoses in terms of dying versus surviving.

Conclusions: The findings illuminate the ways in which commonly used non-numeric language may be understood in numeric terms during prognostic discussions and provide further evidence of recipients' propensity for positive bias.
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http://dx.doi.org/10.1136/bmjspcare-2017-001331DOI Listing
December 2017

Commentary on Wilson et al. (2016): The meaning of success in failure.

Authors:
Anne Moyer

Addiction 2016 12;111(12):2155-2156

Department of Psychology, Stony Brook University, Stony Brook, New York, 11794-2500, USA.

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http://dx.doi.org/10.1111/add.13541DOI Listing
December 2016

Why Psychology Matters in Veterinary Medicine.

Top Companion Anim Med 2015 Jun 22;30(2):43-7. Epub 2015 May 22.

Department of Psychology, Stony Brook University, Stony Brook, NY, USA.

As companion animals become more central to individuals and families, there are countless ways that veterinary medical practice can benefit from understanding human psychology. This article highlights how insights from the fields of health psychology and behavioral medicine might hold the potential to improve veterinary practice. We focus on key areas of care for companion animals that are integrally linked to their human caregivers׳ psychological reactions and behavior, including health maintenance, managing illness, and end-of-life care. We also note ways in which the challenges of skillfully negotiating interactions with companion animal caregivers and other stressful aspects of the veterinary profession may be informed by psychological and behavioral science expertise.
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http://dx.doi.org/10.1053/j.tcam.2015.05.001DOI Listing
June 2015

Attentional Bias for Sexual Threat Among Sexual Victimization Survivors: A Meta-Analytic Review.

Trauma Violence Abuse 2017 04 23;18(2):172-184. Epub 2016 Jun 23.

1 Stony Brook University, Stony Brook, NY, USA.

The current meta-analysis examined the effects of sexual victimization (SV) on attentional bias for sexual threat. This relationship was also examined among victims of SV with and without a current diagnosis of post-traumatic stress disorder (PTSD). The broader aim was to elucidate potential mechanisms operating between SV and negative health outcomes. As hypothesized, the findings supported a positive relationship between SV and attentional bias toward sexual threat stimuli, and subanalyses indicated that PTSD symptomatology significantly contributed to this association.
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http://dx.doi.org/10.1177/1524838015602737DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593786PMC
April 2017

Promoting mammography screening among Chinese American women using a message-framing intervention.

Patient Educ Couns 2015 Jul 30;98(7):878-83. Epub 2015 Mar 30.

Department of Preventive Medicine, Stony Brook University, Stony Brook, USA.

Objectives: This study examined the role of women's perceptions about the relative pros versus cons (decisional balance) of mammography in moderating Chinese American women's responses to gain- and loss-framed messages that promote mammography.

Methods: One hundred and forty-three Chinese American women who were currently nonadherent to guidelines for receiving annual screening mammograms were randomly assigned to read either a gain- or loss-framed culturally appropriate print brochure about mammography screening. Mammography screening was self-reported at a 2-month follow-up.

Results: Although there was not a main effect for message frame, the hypothesized interaction between message frame and decisional balance was significant, indicating that women who received a framed message that matched their decisional balance were significantly more likely to have obtained a mammogram by the follow-up than women who received a mismatched message.

Conclusions: Results suggest that decisional balance, and more generally, perceptions about mammography, may be an important moderator of framing effects for mammography among Chinese American women.

Practice Implications: The match between message frame and decisional balance should be considered when attempting to encourage Chinese American women to receive mammography screening, as a match between the two may be most persuasive.
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http://dx.doi.org/10.1016/j.pec.2015.03.021DOI Listing
July 2015

Brief interventions for alcohol misuse.

CMAJ 2015 Apr 2;187(7):502-506. Epub 2015 Mar 2.

Stony Brook University (Moyer), Stony Brook, NY; Center for Innovation to Implementation (Finney), VA Palo Alto Health Care System, Menlo Park, Calif.

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http://dx.doi.org/10.1503/cmaj.140254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4401596PMC
April 2015

Identity threat and stigma in cancer patients.

Health Psychol Open 2014 Jul 25;1(1):2055102914552281. Epub 2014 Sep 25.

Stony Brook University, USA.

Cancer stigma has undergone an important transformation in recent decades. In general, this disease no longer fits squarely into Goffman's classic taxonomy of stigmatized conditions. This review will demonstrate that, with important adaptations, an identity-threat model of stigma can be used to organize cancer stigma research post-Goffman. This adapted model postulates that one's personal attributions, responses to situational threat, and disease/treatment characteristics can be used to predict identity threat and well-being of individuals with cancer. Implications for further research and clinical practice are discussed.
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http://dx.doi.org/10.1177/2055102914552281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193175PMC
July 2014

Self-affirmation and responses to health messages: a meta-analysis on intentions and behavior.

Health Psychol 2015 Feb 4;34(2):149-59. Epub 2014 Aug 4.

Department of Social and Health Psychology, Stony Brook University.

Objective: The present study aimed to quantify the magnitude of the effect of self-affirmation manipulations on health messages' influence on both intentions and behavior.

Methods: A systematic search was conducted for experimental studies comparing participants who self-affirmed prior to reading a threatening health message to those who did not self-affirm. Effect sizes for health intentions and behaviors were aggregated using a random-effects model.

Results: Data from 16 studies were included. The aggregate effect sizes for intentions and behavior were significant and small in magnitude (d+ = .26, 95% confidence interval [CI] = .04-.48; d+ = .27, 95% CI = .11-.43, respectively). A meta-regression analysis revealed that among studies assessing both outcomes, the size of an effect on intentions did not predict the size of an effect on behavior, β = .03, 95% CI = -.30-.36. Type of health behavior (damaging vs. promoting), timing of the health behavior (proximal vs. distal), type of self-affirmation manipulation (values vs. kindness), and the specificity of the health message (single vs. multiple health issues) did not moderate the effect of self-affirmation on intentions or behavior.

Conclusions: Self-affirmation influences health messages' effect on intentions and behavior; however, with the present study finding that intention effect sizes did not predict behavior effect sizes, and with past studies of heath behavior change finding that intentions do not always translate to behavior, little research supports a causal intention-behavior relation among self-affirmation studies. Future research is needed to address which specific health-related responses explain why self-affirmation elicits health behavior change.
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http://dx.doi.org/10.1037/hea0000110DOI Listing
February 2015

"Would you test your children without their consent?" and other sticky dilemmas in the field of cancer genetic testing.

Fam Cancer 2014 Sep;13(3):345-50

Cancer Genetic Counseling, Yale Cancer Center, Yale School of Medicine, 55 Church Street, Suite 402, New Haven, CT, 06510, USA.

Cancer genetic testing is surrounded by myriad ethical, legal, and psychosocial implications which are being revisited as testing expands into an everyday practice and into more complicated areas like whole exome and direct-to-consumer testing. We chose to survey cancer genetic counselors and physicians from a wide range of non-genetics specialties to determine what they would do if faced with the complex decisions associated with cancer genetic testing, how their views compare, and how they align with current guidelines and data. Genetic counselors were significantly more likely than non-genetics physicians to bill their insurance for testing (94.9 vs. 86.8 %; p = 0.001) and purchase life insurance before testing (86.6 vs. 68.6 %; p = 0.000) and were less likely to use an alias (3.2 vs. 13.2 %; p = 0.000) or order testing on their own DNA (15.3 vs. 24.2 %; p = 0.004). They were also less likely to test their minor children (0.9 vs. 33.1 %; p = 0.000) or test their children without their knowledge and consent/assent (1.4 vs.11.5 %; p = 0.000). The results of our study indicate that there is wide variation regarding what clinicians predict they would do in the areas of ethical, legal and psychosocial issues in cancer genetic testing. Cancer genetic counselors' choices are more aligned with professional guidelines, likely due to their experience in the field and awareness of current guidelines. These data are a starting point for a broader discussion of who should offer cancer genetic counseling and testing to patients, particularly as the complexity of the available testing options and associated issues increase with whole exome sequencing.
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http://dx.doi.org/10.1007/s10689-014-9723-6DOI Listing
September 2014

Low maternal progesterone may contribute to both obstetrical complications and autism.

Med Hypotheses 2014 Mar 14;82(3):313-8. Epub 2014 Jan 14.

Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States.

Studies show increased autism risk among children born to mothers experiencing obstetrical complications. Although this is usually interpreted as suggesting that the obstetrical complications could be causing autism, it is possible that a single factor could be responsible for both complications and autism. We hypothesized that low levels of the hormone progesterone is responsible since it is supplied to the fetus maternally and does not only support pregnancy but also promotes brain development. Following a review of the literature, we report findings from a survey of mothers of autistic children (n=86) compared to mothers of typically-developing children (n=88) regarding obstetrical histories, including five obstetrical risk factors indicative of low progesterone. Using this analysis, the ASD group had significantly more risk factors than controls (1.21 ± 0.09 vs. 0.76 ± 0.08, p<.0001), suggesting low progesterone. Thus, results suggest that low progesterone may be responsible for both obstetrical complications and brain changes associated with autism and that progesterone levels should be routinely monitored in at-risk pregnancies. Our hypothesis also suggests that ensuring adequate levels of progesterone may decrease the likelihood of autism.
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http://dx.doi.org/10.1016/j.mehy.2013.12.018DOI Listing
March 2014

Erratum to: Changes in specialists' perspectives on cancer genetic testing, prophylactic surgery and insurance discrimination: then and now.

J Genet Couns 2015 Apr;24(2):371

Cancer Genetic Counseling, Yale Cancer Center/Yale School of Medicine, 55 Church Street, Suite 402, New Haven, CT, 06510, USA,

Erratum to: J Genet Counsel DOI 10.1007/s10897-013-9625-z . In the “Funding” section, the company HRA was incorrectly referred to as HSR. The full name of the company is “HRA— Healthcare Research & Analytics.”
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http://dx.doi.org/10.1007/s10897-013-9637-8DOI Listing
April 2015

Changes in specialists' perspectives on cancer genetic testing, prophylactic surgery and insurance discrimination: then and now.

J Genet Couns 2014 Apr 13;23(2):164-71. Epub 2013 Jul 13.

Cancer Genetic Counseling, Yale Cancer Center/Yale School of Medicine, 55 Church Street, Suite 402, New Haven, CT, 06510, USA,

We surveyed cancer genetics specialists in 1998 to learn what they would do if at 50% risk to carry a BRCA or Lynch syndrome mutation. We chose to repeat our study 14 years later, to examine how perspectives have changed with the extensive data now available. In July 2012 we surveyed the National Society of Genetic Counselors (NSGC) Cancer Special Interest Group via an internet based survey. We found statistically significant increases in the percentage of specialists who: would undergo BRCA testing (p = 0.0006), opt for prophylactic bilateral mastectomy (p =0.0001), opt for prophylactic removal of their uterus and ovaries for Lynch syndrome (p =0.0057 and P = 0.0090, respectively), and bill testing to insurance (p >0.0001). There were also statistically significant decreases in the percentage of participants who would have their colon removed for Lynch syndrome (p = 0.0002) and use an alias when pursuing testing (p > 0.0001). Over the past 14 years there has been a major change in perspective amongst cancer genetic specialists regarding genetic testing, prophylactic surgery and insurance discrimination.
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http://dx.doi.org/10.1007/s10897-013-9625-zDOI Listing
April 2014

An additional consideration regarding expanding access to testicular tissue cryopreservation: infertility and social stigma.

Am J Bioeth 2013 ;13(3):48-50

Stony Brook University, Department of Psychology, Stony Brook, NY 11794-2500, USA.

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http://dx.doi.org/10.1080/15265161.2012.760683DOI Listing
April 2013