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Reactions to Health-Related Social Control in Young Adults with Type 1 Diabetes

Center for Health Services Research in Primary Care, Veterans Affairs Medical Center, 2424 Erwin Road, Hock Plaza, Suite 1105, P.O. Box 2720, Durham, NC 27705, USA.
Journal of Behavioral Medicine (Impact Factor: 3.1). 09/2007; 31(2):93-103. DOI: 10.1007/s10865-007-9125-4
Source: PubMed

ABSTRACT Health-related social control refers to individuals' attempts to influence another's health behavior. We describe social control experienced by 109 adults aged 18-35 with Type 1 diabetes, and examine the influence of different types of social control on behavioral and psychological outcomes. Using a self-administered questionnaire, telephone interview, and chart review, we assessed individuals' social control experiences, behavioral and psychological reactions, psychological adjustment, metabolic control, socio-demographics, and clinical factors at baseline, and psychological adjustment and metabolic control at 6-months follow-up. Most participants (85%) reported experiencing social control. Regression analyses revealed that more frequent negative control predicted less behavior change and more negative cognitive reactions concurrently, and decreases in psychological adjustment over time. More frequent reinforcement/modeling and structural changes predicted more positive emotional reactions, but were not associated with behavior change, psychological adjustment, or metabolic control. Use of direct persuasion was associated with more pretending of behavior change. These results suggest that negative social control attempts by social network members may be counter-productive.

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    • "Some studies find evidence of improved adherence to a medical regimen (Fekete et al., 2009; Stephens, Fekete, Franks, Rook, Druley, & Greene, 2009), whereas other studies find evidence of worse health behaviors (Franks et al., 2006; Helgeson et al., 2004; Thorpe et al., 2008). In terms of the impact on recipients' psychological health, preliminary evidence suggests that patients do experience psychological distress, or negative emotions, in response to social control in the context of a chronic illness (Helgeson et al., 2004; Stephens et al., 2009; Thorpe, 2008). For example, in a study by Stephens and colleagues (2009) of older adults with osteoarthritis who were recovering from knee replacement, more coercive forms of social control were related to negative emotions. "
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    • "Research on the effects of social control strategies consistently find negative social control tactics to be unrelated to health behavior change (including smoking cessation) and to predict negative psychological reactions, such as hostility/irritation or sadness/ guilt (Lewis & Rook). The effects of positive social control strategies , however, are less consistent, with studies showing either positive (Lewis & Rook; Tucker et al.) or null effects on behavior change (Helgeson, Novak, Lepore, & Eton, 2004; Thorpe, Lewis, & Sterba, 2008). Although not depicted in Figure 1, positive and negative social control tactics may influence quitting not only through their effects on affect (as examined in prior research) but possibly by influencing motivation to quit as well. "
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