Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Exp Clin Psychopharmacol. 2012 Feb;20(1):56-62. doi: 10.1037/a0025482. Epub 2011 Sep 12.
Social learning theory considers self-efficacy as a causal factor in behavior change. However, in line with behavioral theory, recent clinical research suggests self-efficacy ratings may reflect, rather than cause, behavior change. To test these two disparate views, self-efficacy was related to actual smoking abstinence on the next day (i.e., self-efficacy causes change), and abstinence status over 1 day was tested as a predictor of rated self-efficacy for quitting the next day (i.e., reflects change). All data were from two similar crossover studies evaluating the short-term effects of both placebo versus medication, nicotine patch (n = 209) or varenicline (n = 123), on smoking abstinence during week-long practice quit attempts. Placebo and active medication periods were separated by an ad lib smoking washout, and analyses were controlled for prior-day's abstinence or self-efficacy values. Results were very consistent between studies in showing essentially bidirectional associations: daily self-efficacy predicted next-day's abstinence, and current-day's abstinence status predicted self-efficacy for abstinence the next day. However, secondary factors differentially predicted abstinence and, to a lesser extent, self-efficacy, between these two medication studies. These data provide some support for both social learning and behavioral theories of smoking behavior change, although self-efficacy may only briefly predict subsequent short periods of abstinence as assessed in these studies. Nonetheless, because self-efficacy has long been assumed to cause behavior change, including smoking cessation, the notion of self-efficacy as a reflection of recent smoking behavior change in these studies warrants greater attention in clinical research on smoking cessation treatment.
社会学习理论认为自我效能感是行为改变的一个因果因素。然而，与行为理论一致，最近的临床研究表明，自我效能感评分可能反映而不是导致行为改变。为了检验这两种截然不同的观点，将自我效能感与次日的实际戒烟情况（即自我效能感导致改变）联系起来，并检验次日的戒烟状态是否可以预测自我效能感评分（即反映改变）。所有数据均来自两项类似的交叉研究，评估了安慰剂与药物（尼古丁贴片[209 人]或伐伦克林[123 人]）在为期一周的戒烟尝试中对戒烟的短期影响。在自由吸烟洗脱期后，安慰剂和活性药物期被分开，分析时控制了前一天的戒烟或自我效能感值。这两项研究的结果非常一致，表明基本上存在双向关联：每日自我效能感预测次日的戒烟情况，而当前的戒烟状态预测次日的戒烟自我效能感。然而，次要因素在这两项药物研究中对戒烟和在较小程度上对自我效能感的预测作用存在差异。这些数据为吸烟行为改变的社会学习和行为理论提供了一些支持，尽管自我效能感可能仅在这些研究中短暂地预测随后的短期戒烟期。尽管如此，由于自我效能感长期以来一直被认为会导致行为改变，包括戒烟，因此在这些研究中，自我效能感作为近期吸烟行为改变的反映这一观点值得在戒烟治疗的临床研究中引起更多关注。
