Evaluation of Decisional Balance in Change of Effective Stress Management Behavior among Chinese University Participants Using Item Response Theory


The transtheoretical model defines behavior change as progression through five stages: precontemplation (not ready), contemplation (getting ready), preparation (readiness), action, and maintenance. Decisional balance (i.e., the relative weight of the pros and cons of making a change) is assumed to mediate stage progression. As one progresses through the stages, the model predicts that the balance of pros increases while that of cons decreases. Previous studies have confirmed this; these results may be attributed to differing response patterns to each item of the decisional balance measure across the stages. This study examines the relationship between decisional balance and the stages of change related to effective stress management behavior (i.e., any healthy activity to manage stress) using a decisional balance measure based on item response theory. The participants were 447 male and 602 female college students. A six-item scale of decisional balance was developed. The balance of pros was significantly higher in later stages such as action and maintenance stages relative to earlier stages such as precontemplation and contemplation stages, while the opposite held for the cons. These results provide strong evidence that the correspondence between decisional balance and the stage of change can be applied to stress management behavior.

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Deng, K. , Tsuda, A. , Horiuchi, S. and Matsuda, T. (2013) Evaluation of Decisional Balance in Change of Effective Stress Management Behavior among Chinese University Participants Using Item Response Theory. Open Journal of Social Sciences, 1, 12-17. doi: 10.4236/jss.2013.16003.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Darling, C. A., McWey, L. M., Howard, S. N., & Olmstead, S. B. (2007). College student stress: The influence of interpersonal relationships on sense of coherence. Stress and Health, 23, 215-549. http://dx.doi.org/10.1002/smi.1139
[2] Deng, K., Tsuda, A., Horiuchi, S., Kim, E., & Wu, X. (2012). Development of the Chinese version of the algorithm of stage of change for stress management behavior confirmation of the reliability and validity. Kureume University Psychological Research, 11, 1-7.
[3] Dodd, B. G., de Ayala, R. J., & Koch, W. R. (1995). Computerized adaptive testing with polytomous items. Applied Psychological Methods, 19, 5-22.
[4] Embreston, S.E., & Reise, S.P. (2000). Item response theory for psychologists. Mahwah, NJ: Lawrence Erlbaum.
[5] Evers, K. E., Prochaska, J. O., Johnson, J. L., Mauriello, L. M., Padula, J. A., & Prochaska, J. M. (2006). A randomized clinical trial of a population and transtheoretical model-based stress management intervention. Health Psychology, 25, 521-529. http://dx.doi.org/10.1037/0278-6133.25.4.521
[6] Fava, J. L., Norman, G. J., Levesque, D. A., Redding, C. A., Johnson, S., Evers, K., & Reich, T. (1998). Measuring decisional balance for stress management. In Nineteenth annual scientific sessions of the society of behavioral medicine, New Orleans, 25-28 March 1998.
[7] Greenberg, J. S. (2010). Comprehensive stress management (12th ed.). New York: McGraw-Hill Companies.
[8] Hall, K. L., & Rossi, J. S. (2008). Meta-analytic examination of the strong and weak principles across 48 health behaviors, Preventive Medicine, 46, 266-274. http://dx.doi.org/10.1016/j.ypmed.2007.11.006
[9] Horiuchi, S., Tsuda, A., Kim, E., Hong, K.S., Park, Y.S., & Kim, U. (2010). Relationships between stage of change for stress management behavior and perceived stress and coping. Japanese Psychological Research, 52, 291-297. http://dx.doi.org/10.1111/j.1468-5884.2010.00444.x
[10] Horiuchi, S., Tsuda, A., Kim, E., Morita, T., & Kobayashi, H. (2013). Effectiveness of the expert system for modifying effective stress management behavior based on the transtheoretical model in college students. Stress Management Research, 9, 9-24.
[11] Horiuchi, S., Tsuda, A., Kobayashi, H., & Prochaska, J. M. (2012). Reliability and validity of the Japanese language version of Pro-Change’s decisional balance measure for effective stress management (PDSM). Japanese Psychological Research, 54, 128-136. http://dx.doi.org/10.1111/j.1468-5884.2011.00490.x
[12] Horiuchi, S., Tsuda, A., Tanaka, Y., Okamura, H., Yajima, J., & Tsuda, S. (2009). Stage of change distribution in stress management behavior in Japanese university students. Japanese Journal of Health Promotion, 11, 1-8.
[13] Ironson, G. G., Smith, P. C., Brannick, M. T., Gibson, W. M., & Paul, K. B. (1989). Construction of a job in general scale: A comparison of global, composite, and specific measures. Journal of Applied Psychology, 74, 193-200. http://dx.doi.org/10.1037/0021-9010.74.2.193
[14] Kessler, R. C., Gollust, S. E., Golberstein, E., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archives of General Psychiatry, 62, 593-602. http://dx.doi.org/10.1001/archpsyc.62.6.593
[15] Mauriello, L. M., Rossi, J. S., Fava, J. L., Redding, C. A., Robbins, M., Prochasa, J. O., & Meier, K. S. (2007). Assessment of the pros and cons of stress management among adolescents: Development and validation of a decisional balance measure. American Journal of Health Promotion, 22, 140-143. http://dx.doi.org/10.4278/0890-1171-22.2.140
[16] Pro-Change Behavior Systems, Inc. (2003). Road to healthy living: A guide for effective stress management. Kingston, RI: Pro-Change Behavior Systems, Inc.
[17] Prochaska, J. O., Butterworth, S., Redding, C. A., Burden, V., Perrin, N., Leo, M., Flahertty Robb, M., & Prochasak, J. M. (2008). Initial efficacy of MI, TTM tailoring and HRI’s with multiple behaviors for employee health promotion. Preventive Medicine, 46, 226-231. http://dx.doi.org/10.1016/j.ypmed.2007.11.007
[18] Prochaska, J. O., DiClemente, C. C., & Norcross J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114. http://dx.doi.org/10.1037/0003-066X.47.9.1102
[19] Riley, T. A., & Fava, J. L. (2003). Stress and transtheoretical model indicators of stress management behaviors in HIV-positive women. Journal of Psychosomatic Research, 54, 245-252. http://dx.doi.org/10.1016/S0022-3999(02)00603-7
[20] Samejima, F. (1969). Estimation of latent ability using a response pattern of graded scores. Psychometrika Monograph No. 17, Richmond: Psychometric Society.

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