This paper reports the results of methodological studies carried out in conjunction with the US National Comorbidity Survey (NCS) to evaluate Version 1.0 of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDItured instrument like the CIDI in the NCS because of the large sample size, the enormous geographic dispersion of the sample, and the prohibitive costs and logistic complications of the study. The NCS was the first large-scale general population survey to administer the CIDI in the United States. Although WHO CIDI Field Trials carried out prior to the NCS documented good performance of the instrument (Wittchen 1994), the field trials were conducted largely in clinical samples and administered in clinical settings. As a result, we considered it very important to carry out pretests before using the instrument in a community sample.As described more fully below, the NCS pretests were guided by the literature on survey data collection methodology (e.g. Bradburn et al. 1979; Moss and 33
Particularly in the health domain, humans thrive to reach an equilibrium between maximizing pleasure and minimizing harm. We propose that a cognitive strategy people employ to reach this equilibrium is the activation of Compensatory Health Beliefs (CHBs). CHBs are beliefs that the negative effects of an unhealthy behaviour can be compensated for, or "neutralized," by engaging in another, healthy behaviour. "I can eat this piece of cake now because I will exercise this evening" is an example of such beliefs. Our theoretical framework aims at explaining why people create CHBs and how they employ CHBs to regulate their health behaviours. The model extends current health behaviour models by explicitly integrating the motivational conflict that emerges from the interplay between affective states (i.e., cravings or desires) and motivation (i.e., health goals). As predicted by the model, previous research has shown that holding CHBs hinder an individual's success at positive health behaviour change, and may explain why many people fail to adhere to behaviour change programs such as dieting or exercising. Moreover, future research using the model and implications for possible interventions are discussed.
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