| Summary: | Particularly in the health domain, humans thrive to reach an equilibrium between maximizing pleasure and minimizing harm. I 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 behavior can be compensated for, or "neutralized," by engaging in another, healthy behavior. "I can eat this piece of cake now because I will exercise this evening" is an example of such beliefs. This thesis presents a theoretical framework which aims at explaining why people create CHBs and how they employ CHBs to regulate their health behaviors. The model extends current health behavior 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). The first study includes a psychometric scale that measures CHBs in the general population and provides data on its reliability and validity. The results showed that scores on the scale were uniquely associated with health-related risk behaviors and symptom reports and could be differentiated from a number of related constructs. Holding CHBs may hinder individuals from acquiring healthier lifestyles, for example lose weight or exercise. The second large-scale study of this thesis aimed at studying CHBs in adolescents with type 1 diabetes. It is proposed that in this population, CHBs might interfere with treatment adherence. If compensatory behaviors fail to compensate for the maladaptive behaviors, poor blood glucose control and related health problems may arise. To investigate this further, I developed and validated a CHB scale specific to type 1 diabetes. The scale was validated in a sample of adolescents with type 1 diabetes. Results showed that holding maladaptive compensatory health beliefs was associated with poorer blood glucose control and poorer adherence to self-care behaviors while adaptive CHBs were associated with better blood glucose control and better adherence to treatment behaviors. Specifically targeting CHBs in an intervention could improve adherence to treatment and therefore the long-term health of this population. Future research as well as the implications for possible interventions are explicitly being discussed.
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