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Application of the Transtheoretical Model of Change to Laura-Lee Application of the Transtheoretical Model of Change to Binge Eating and Smoking Laura-Lee Clausen Oc a thesis submitted to the Department of Psychology in confomity with the requirements for the degree of Master of Arts Lakehead University Thunder Bay, Ontario, Canada Septemkr, 1 999 National Library Bibliothby nationale du Cana a uisitions ad Acquisitions et abgraphic SMvices semices bibliographiques The author has granted a non- L'auteur a accordé une Licence non exclusive licence aüowing the exclusive permettant à la National Librsry of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or seU reproduire, prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/6im, de reproduction sur papier ou sur format électronique. The author retahs ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts fiom it Ni La thèse ni des extraits substantiels may be printed or otherwise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. Abstract Applicability of the stage of change and decisional balance constnicts for bingers and smokers was examined in a study of 191 participants; bingers (n = 47), smokers (n = 80). and conbols (n = 64). The Stage of Change Inventory (SCI) was cross-validated with the University of Rhode Island Change Assessrnent (URiCA) sale and used to assign bingers and smokers to one of five stages of change; precontemplation, contemplation. action, maintenance, and recovery. Psychological distress, the characteristics of binge eating and smoking, and the pros and cons of behavioural change were evaluated as a function of the stages of change. Although an increase in the con scores fiom precontemplation to action did not support the weak principle of the decisional balance. an increase in the pros of behavioural change fiom precontemplation to action provided support for the strong principle for bingea and smokers. Results of the Brief Symptom Inventory (BSI) indicated that psychological distress was not related to stage of change for bingers or smokers. However, bingers were found to score significantly higher than controls on the Global Seventy Index (GSI) of the BSI. Several measures were used to hinhet explore the phenomenology of binge eating and smoking. Results of the Binge Eating Adjective Checklist (BEAC) and Smoking Adjective Checklist (SAC) suggested that both khaviom serve a fwction in reducing the amount of psychological distress experienced by participants. For bingers, degree of loss of control and negative affect were found to Vary as a function of stage of change, with precontemplators experiencing the least negative consequences associated with their behaviour and action-takea the most. The overail findings support the applicability of the transtheoretical mode1 for bingers and smokers and furthet suggest that stage of change is rclated to characteristics of binge eating such as negative affect and loss of control. Acknowledgements First, 1 would Iike to express my most sincere uianks to my thesis supervisor, Dr. Ron Davis, for his support, luiowledge, and understanding throughout the entire process of this study . 1 would also like to thank Dr. J. Jarnieson, Dr. D. Franko, and Professor K. Ailan for their &ce and comrnents regarding this work. On a persona1 Ievel, 1 would like to thank Shannon Costigm and Kristim Isfeld for their understanding, patience, and encouragement thmughout the completion of this work, especiaily the last few months. Lady, I would like to thank my parents and brocher, for without their continued encouragement and love 1 would not ôe who or where I am toàay. Table of Contents Page Abstract ................................................................................................. i .. Acknowledgements................................................................................... 11 List of Tables .......................................................................................... iv Lia of Figures ......................................................................................... .v Introduction............................................................................................ 1 Stages'of Change .............................................................................1 Decisionai Balance ..........................................................................2 Smoking ........................................................................................4 The Strong and Weak hcipies of Change ............................................... 6 The Transtheoretid Model and Binge Eating ...........................................7 Binge Eating and Psychopathology ........................................................ 9 Phenomenology of Binge Eating and Smoking ......................................... 10 Purposes and Hypothcses of the Present Study .........................................11 . Method ................................................................................................12 Participants................................................................................. -12 Measures..................................................................................... -12 Scmning instrument for Behaviours .......................................... -12 Stage of Change Invcntory ........................................................13 University of Rhode Island Change Assessrnent Scalc - Reviscd .........-13 Behaviourd Characteristics of Binge Eating and Smoking ..................14 Decisional Balance for Binge Eating and Smoking........................... 15 Brief Symptom Invcntory .........................................................15 Bbge Eating Adjective Checklist and Smoking Adjective Checklist ...... 16 bdts................................................................................................ -16 Chatacteristics of Participants................................................... 16 himilil Consistnicies of Maures............................................. 18 Cladfication of Participants into Stage of Change ...........................18 Stage of Change and Decisional Balance ...................................... 19 Bnef Symptom uivcntory Scores for Group and Stage of Change ......... 28 Pbenomcnology of the Behaviours .............................................. 31 Summiry of Findings ............................................................. 40 Discussion............................................................................................ 41 References............................................................................................ 48 Appendices .............. .... ......................................................................... 55 iii List of Tables Table Page 1 Characteristics of Participants .........................................................17 2 Distribution of the Number of Particijmts Acwrding to Group and the Stage of Change Inventory ........................... ............................... -20 Decisional Balance Scores as a Function of Stage of Change for Bingers ......21 Decisional Baiance Scores as a Function of Stage of Change for Smokers..... 23 Difierences ktween Groups on the Bnef Symptom Inventory ..................29 kief Symptom Inventory Global Severity Index as a Function of Stage of Change for Bingers and Srnoken.................................................. 32 Behavioural Characteristics Scales (Part II) as a Function of Stage of Change for Bingea ......................................................................36 khavioural Characteristics Scales (Pari Il) as a Function of Stage of Change for Smokers.................................................................... 38 Behavioural Characteristics Scales (Part 1) as a Function of Stage of Change for Bingea ...................................................................... 39 khavioural Characteristics Scaies (Part 1) as a Function of Stage of Change for Smokers.................................................................... 41 List of Figures Page + 1 Standerdized TScons for the pro and con desof the Decisional 1 Balance measure plotted as a hction of stage of change for bingers.. .. .24 I ... i 2 Standardized Escores for the pro and con scales of the Decisional I Balance measure plotted as a hction of stage of change for smokers.. .. .... 26 3 Binge Eating Adjective Checklist end Smoking Adjective Checkiist 1 composite scores for bingers and smokers plotted as a fùnction of time.. .. .3 3 Introduction An increased awareness of health-related issues and behaviours has contributed to the development of programs and techniques to assist individuals in changing their behaviour (Prochaska, Nmss, dé DiClemente, 1994). in 1982, Prochaska and DiClemente developed a therapeutic approach based on a synthesis of the processes of change fowid to be cornmon arnong 18 different therapy systems, known as the ~stheoreticalmodel. This integrative model of bchavioural change was extended to include addictive and problem behaviours such as smoking (Prochaska & DiClemente, 1983) and weight control (O'Connell, & Velicer, 1988). A Merconstruct of the model, decisional balance, has been found to Vary as a fùnction of an individual's motivation to change (Prochaska 1994). The present study involved
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