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Dan V Blalock,1,2 Patrick E McKnight,3 Todd B Kashdan,3 Simone C Franz3,4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; 3Department of Psychology, George Mason University, Fairfax, VA, USA; 4Humanproof, LLC, Arlington, VA, USA Objective: The present study examined the proposition that patients need to focus on something beyond simply “getting better”. In a sample of arthritis sufferers, we distinguished individuals by the goals that motivated them – moving toward aspirational goals and maximizing gains (promotion focus) rather than obligations and minimizing losses (prevention focus) – and how these motivational styles influenced treatment. Methods: Patients (N=254) participated in a randomized controlled trial of resistance training and self-management, providing 6 time points of data over 2 years. Promotion and prevention focus at baseline were used to predict the course (compliance and changes in coping self-efficacy) and outcome (changes in physical functioning) of treatment. Results: Arthritis sufferers with strong promotion orientations showed significant improvements in physical functioning (a direct positive impact on physical health); there were no significant associations with treatment compliance and coping self-efficacy. Arthritis sufferers with strong prevention orientations complied less with the treatment and showed little change in coping self-efficacy during treatment, which, in turn, predicted worse physical functioning over time (a pernicious, indirect influence on treatment outcome). Conclusion: A focus on positive approach-oriented goals may improve overall treatment response, whereas a focus on negative avoidance-oriented goals may degrade treatment response through reduced compliance and self-efficacy. Keywords: treatment, promotion and prevention, self-efficacy, physical functioning, arthritis

The purpose of this study was to assess the relative effects of coping self-efficacy and catastrophizing on physical functioning. Over a 9-month period, studying changes in self-efficacy as possible mediator between catastrophizing changes and physical functioning changes might provide evidence for the most promising treatment target. Data came from a randomized, longitudinal controlled trial comparing exercise, self-management and the two combined to treat 254 individuals with early knee osteoarthritis. A secondary analysis using a bootstrapped linear mixed-effects mediational model produced estimates of both the direct and indirect effects. Results indicated that self-efficacy partially mediated the effect between catastrophizing and physical functioning suggesting that self-efficacy was the more direct treatment target compared to catastrophizing. Treatments targeting both self-efficacy and catastrophizing may have greater impact on physical functioning compared to treatments that focus on only one. [ABSTRACT FROM AUTHOR]

This study assessed the psychometric properties and evaluated the compatibility of two blind and low-vision rehabilitation outcome instruments, the VA-13 and the Functional Assessment of Self-Reliance on Tasks (FAST). Legally blind veterans (N = 190) from a Department of Veterans Affairs inpatient blind rehabilitation center completed the VA-13 (a retrospective pretest and posttest) at 6 weeks postdischarge. Clinicians rated veterans on the FAST at admission and discharge. The psychometric properties of the two instruments and their compatibility were evaluated with the use of a Rasch model analysis. The two instruments functioned consistently as screens and showed a ceiling effect at posttest; however, the VA-13 showed poor sensitivity to change. In contrast, the FAST showed more reliable change, hut a few items changed in unexpected ways. Our conclusions show that the two instruments are currently not compatible for calibration; however, this can he improved with proper attention to scaling inadequacies, test administration times, and content coverage. [ABSTRACT FROM AUTHOR]

Perseveration has been described as a reliable indicator of disturbed brain function and is a common characteristic of neurological conditions such as Alzheimer's disease (AD). This article will begin with a review of recent theories that account for the phenomenon of perseveration, and data from a National Institute on Deafness and Other Communication Disorders (NIDCD)--supported study further delineate the nature of perseveration among individuals with AD. The study investigated the frequency of verbal perseveration in individuals with AD in relation to task type, mental status, and performance on attention and memory tests. Thirty Alzheimer's patients and 40 healthy elders were given a confrontation naming, generative naming, and picture description test. Perseveration was defined as a proportion of total number of responses. Data analysis revealed that individuals with AD perseverated more than normal elders did, but variability was high. Generative naming elicited more perseveration than either confrontation naming or picture description did. When overall frequency of perseveration was correlated with mental status and performance on attention and memory tests, seemingly paradoxical results were obtained, probably because the unique cognitive demands of each language test affected the probability of perseveration differently. Nonparadoxical, strong positive correlations were obtained, however, between language test scores and performance on tests of attention, memory and mental status. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the plausibility of self-control depletion, or ego-depletion, as the underlying cognitive resource responsible for performance decrements on the sustained attention to response task., Background: Researchers suggested that self-control is a limited cognitive resource used to complete a myriad of processes, including sustained attention. Past research showed that trait self-control affects some sustained attention tasks. However, little research has investigated the effect of self-control as a limited cognitive resource that varies over time (i.e., as a state-dependent variable)., Methods: This experiment investigated the effect of self-control (trait and state) on a sustained motor-inhibition task (e.g., sustained attention to response task; SART). State self-control was manipulated using a between-subjects design-participants in the experimental condition completed a task designed to deplete state self-control prior to performing the SART while the control condition completed a modified version that did not deplete self-control., Results: Trait self-control predicted performance on the SART, but the depletion task (state self-control) had no detectable effect., Conclusion: Given the evidence, it is unlikely that state self-control plays a causal role in performance decrements in the SART, but there appears to be some association between performance on the SART and trait self-control., Application: Trait self-control ought to be considered in future work for personnel selection in real-world tasks that the SART models such as long-distance driving, air traffic control, and TSA operations.

Theoretically, purpose serves as a basic dimension of healthy psychological functioning and an important protective factor from psychopathology. Theory alone, however, is insufficient to answer critical questions about human behavior and functioning; we require empirical evidence that explores the parameters of purpose with respect to measurement, prediction, and modification. Here, we provide empirically supported insights about how purpose can operate as a beneficial outcome (e.g., marker of well-being), a predictor or mechanism that accounts for benefits that a person derives (such as from an intervention), or a moderator that offers insight into when benefits arise. Advancing the study of purpose requires careful consideration of how purpose is conceptualized, manipulated, and measured across the lifespan. Our aim is to help scientists understand, specify, and conduct high-quality studies of purpose in life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The unbridled positivity toward curiosity and creativity may be excessive. Both aid species survival through exploration and advancement. These beneficial effects are well documented. What remains is to understand their optimal levels and contexts for maximal achievement, health, and well-being. Every beneficial element to individuals and groups carries the potential for harm - curiosity and creativity included.

Head-up displays (HUDs) have the potential to change work in operation environments by providing hands-free information to wearers. However, these benefits may be accompanied by trade-offs, primarily by increasing cognitive load due to dividing attention. Previous studies have attempted to understand the trade-offs of HUD usage; however, all of which were focused on land-based tasks. A gap in understanding exists when examining HUD use in aquatic environments as immersion introduces unique environmental and physiological factors that could affect multitasking. In this study, we investigated multitasking performance associated with swimming with a HUD. Eighteen participants completed three tasks: swimming only, a HUD-administered word recall task, and a dual-task combining both tasks. Results revealed significant dual-task interference in both tasks, though possibly less pronounced than in land-based tasks. These findings enhance not only help characterise dual-task performance, but also offer valuable insights for HUD design for aquatic settings.

Objectives: We investigated the effects of auditory cues of varying reliability levels on response inhibition performance using a target detection task to determine if external cues offer performance benefits. Further, we examined how the slope of the speed accuracy trade-off changes as a function of auditory cue reliability and used the trade-off to understand where any performance gains may be realized., Background: Researchers have proposed that the sustained attention to response task (SART) can be used to study the mechanisms causing failures of response inhibition. External cues may mitigate the results of motor inhibition failure. The extent to which external cues can effectively aid performance depends on the level of cue reliability., Method: Ninety-one participants performed three SARTs with auditory cue assistance at three different levels of reliability (i.e. 0%, 60% and 100% reliable at cueing imminent No-Go stimuli)., Results: We observed fewer errors of commission and faster reaction time in conditions with higher cue reliability. The slope of speed-accuracy trade-off relationship was impacted by cue reliability and was not a simple linear function., Conclusion: Reliable auditory cues aid performance by reducing reaction time and errors of commission. Auditory cues also impact the relationship between speed and accuracy trade-off., Application: Insights of cue effectiveness at different reliability levels help people make informed decisions in developing automation interfaces or sensors based on expected performance. Reliable cues mitigate the risk of impulsive errors; however, the reliability has to be high to have a noticeable impact on the speed-accuracy trade-off., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Little is known about factors that influence dentists' decision making concerning antibiotic prophylaxis (AP) prescribing. The objective of this study was to determine factors that influence dentists' AP prescribing habits in patients at risk of developing infective endocarditis and prosthetic joint infections., Methods: A questionnaire was administered to 3,584 dentist members of The National Dental Practice-Based Research Network. In addition to descriptive statistics, ordinal regression models were used to determine the factors most likely to impact dentists' decisions to prescribe AP., Results: Overall, 2,169 (61%) dentists in The National Dental Practice-Based Resesarch Network responded. Responders' decisions to prescribe antibiotics were influenced primarily by official guidelines, scientific literature, and physician or medical specialist opinion. Regarding potential risks, the greatest level of concern was for the development of infective endocarditis or prosthetic joint infections. Although litigation was deemed problematic, more than 90% of responders indicated a strong concern for the best course of action for the patient's health. Dentists also indicated a high level of concern about the potential for generating antibiotic-resistant bacteria with AP use and increased risk of adverse drug reactions., Conclusions: Dentists' AP decision making seems most influenced by official guidelines, scientific literature, and advice from a physician or medical specialist., Practical Implications: These results suggest that one of the most effective means for promoting concordance of dentists clinical practice with the scientific basis for AP is to emphasize the importance and clarity of American Heart Association and American Dental Association recommendations and antimicrobial stewardship regarding prevention of infective endocarditis and prosthetic joint infections., (Copyright © 2022 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Emotion-driven impulse control difficulties are associated with negative psychological outcomes. Extant research suggests that high frequency heart rate variability (HF-HRV) may be indicative of emotion-driven impulse control difficulties and potentially moderated by negative emotion. In the current study, 248 eleven- to 14-year-olds and their parent engaged in a negatively emotionally arousing conflict task at Time 1. Adolescents' HF-HRV and negative emotional expression and experience were assessed before, during, and/or after the task. Adolescents reported on their levels of emotion-driven impulse control difficulties at Time 1 and one year later. Results revealed that higher levels of HF-HRV reactivity (i.e., higher HF-HRV augmentation) predicted higher levels of emotion-driven impulse control difficulties one year later among adolescents who experienced higher negative emotion. These findings suggest that negative emotional context should be considered when examining HF-HRV reactivity as a risk factor for emotion-driven impulse control difficulties and associated outcomes.

Background: Little is known about antibiotic prescribing practices of dentists. The objective of this study was to gain a better understanding of dentists' beliefs and behaviors regarding the use of antibiotic prophylaxis (AP) before invasive dental procedures., Methods: A multidisciplinary team developed and disseminated a questionnaire to 3,584 dentist members of the National Dental Practice-Based Research Network., Results: Overall, 2,169 network dentists (61%) responded. Respondents saw patients at risk of developing infective endocarditis (IE) and prosthetic joint infection (PJI) at least once per week (35% and 65%, respectively). Although 78% of dentists agreed that the 2007 American Heart Association guidelines for the prevention of IE are well-defined and clear, only 49% agreed concerning PJI guidelines. Differences for the IE and PJI patient populations also existed for questions regarding dentists' understanding of the specific patient groups at risk, the recommended antibiotic regimens, and the need to consult with a patient's cardiologist or orthopedic surgeon., Conclusions: The survey results indicate that decision making regarding the use of AP occurs frequently among dentists. Moreover, dentists reported uncertainty about the appropriate use of AP as defined by both IE and PJI guidelines, which may have resulted in a lack of concordance between dentists' beliefs and their practice behaviors., Practical Implications: The results reported by the authors highlight the need to develop better educational programs that address antimicrobial stewardship in AP for patients at risk of developing IE and PJI and target the dental profession., (Copyright © 2020 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Psychological flexibility (PF), defined as the ability to pursue valued life aims despite the presence of distress, is a fundamental contributor to health (Kashdan & Rottenberg, 2010). Existing measures of PF have failed to consider the valued goals that give context for why people are willing to manage distress. Using 4 independent samples and 3 follow-up samples, we examined the role of PF in well-being, emotional experience and regulation, resilience, goal pursuit, and daily functioning. We describe the development and psychometric properties of the Personalized Psychological Flexibility Index (PPFI), which captures tendencies to avoid, accept, and harness discomfort during valued goal pursuit. Correlational, laboratory, and experience-sampling methods show that the PPFI measures a trait-like individual difference dimension that is related to a variety of well-being and healthy personality constructs. Unlike existing measures of PF, the PPFI was shown to be distinct from negative emotionality. Beyond trait measures, the PPFI is associated with effective daily goals and life strivings pursuit and adaptive emotional and regulatory responses to stressful life events. By adopting our measurement index, PF may be better integrated into mainstream theory and research on adaptive human functioning. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background: Dentists are high prescribers of antibiotics for both treatment and prevention of infection, although there are few guidelines to aid clinicians. Given the worldwide concerns about unnecessary use of antibiotics, there is a need for a better understanding of dentists' use of these drugs for antibiotic prophylaxis (AP) to prevent distant site infections (i.e., infective endocarditis and prosthetic joint infection)., Objective: The aim of this study was to develop and implement an effective, self-reporting, cross-sectional, survey instrument that optimized the response rate and maximized reliability and validity for determining the beliefs and behaviors of a large and nationally representative group of generalist and specialist dentists concerning their use of AP., Study Design: A 15-question survey (58 items) was developed in a structured process by a multidisciplinary team and configured for automated online dissemination to 3584 national Dental Practice-Based Research Network (DPBRN; hitherto referred to as "Network") practitioners. The implementation phase consisted of 3 waves of greater than 1000 Network members. Additionally, 47 randomly selected dentists were surveyed twice to assess test-retest reliability., Results: Of 3584 eligible Network members, 2169 (60.5%) completed the survey. The age and geographic distributions of responders was similar to those of dentists in the 2019 American Dental Association census. Furthermore, test-retest weighted kappa values for the survey were acceptable (median 0.56; interquartile range 0.42-0.64)., Conclusions: We developed a highly structured survey with a high response rate and good reliability that will allow us to obtain unique data on dentists' beliefs and practices regarding AP prescribing., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Detecting a pattern within a sequence of ordered units, defined as patterning, is a cognitive ability that is important in learning mathematics and influential in learning to read. The present study was designed to examine relations between first-grade children's executive functions, patterning, and reading abilities, and to examine whether these relations differ by the type of pattern. The results showed that working memory correlated with reading fluency, and comprehension measures. Inhibition correlated only with the latter. Cognitive flexibility was correlated with patterning performance and with performance on object size patterns, whereas working memory was correlated with performance on symmetrical patterns and growing number patterns. These results suggest that the cognition required for completing patterns differs depending on the pattern type. Teachers may find it beneficial to place emphasis on the switching and working memory components of completing patterning tasks, depending on the type of patterns used in instruction.

Sex is rarely discussed in theories of well-being and rarely empirically examined using methods other than cross-sectional surveys. In the present study, a daily diary approach was used (for 21 days with 152 adults) to explore the relationship between the presence and quality of sexual episodes and well-being (positive affect, negative affect, meaning in life). Time-lagged analyses demonstrated that sexual activity on 1 day was related to greater well-being the next. As for the quality of episodes, higher reported sexual pleasure and intimacy predicted greater positive affect and lower negative affect the following day. When the reverse direction was tested, well-being did not predict next-day sexual activity, pleasure, or intimacy. These results suggest a unidirectional relationship in which the presence and quality of sexual activity lead to gains in well-being the following day. Contextual moderators (gender, relationship status, relationship closeness, and relationship length) allowed for tests of conditions altering the link between sexuality and well-being. Relationship closeness was the most robust moderator in predicting greater levels of meaning in life and positive affect following sexual episodes. These data provide evidence to support the continual consideration of sex in empirical work and theoretical models of elements that comprise healthy relationships and a good life. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Individuals with Social Anxiety Disorder (SAD) have difficulty engaging in social situations because their actions are predicated on minimizing the subjectively biased high potential for rejection. That is, individuals with SAD frequently perceive social situations as challenging, and their performance as subpar. Yet when individuals perceive themselves as succeeding in challenging situations, they typically report these situations as enjoyable and rewarding. This subjective experience of succeeding in a challenging situation has been studied as flow (Csikszentmihalyi, 1975; 2000). Thirty-three adults with SAD and 34 matched healthy controls completed a baseline assessment, along with daily and experience sampling entries for 14 days. Results were analyzed using three-level generalized linear mixed effects models, with observations nested within days, nested within participants. Although individuals with and without SAD experienced the same frequency of flow in daily life, social situations led to proportionally more flow in participants with SAD than healthy controls. Both results were unexpected, and reasons for them are explored at length. Several experiential variables (positive emotions during and importance ascribed to the event) predicted the probability of flow during each situation. These results offer intervention-relevant suggestions for how individuals may benefit from seeking out challenging situations that offer maximal rewards., (Published by Elsevier Ltd.)

Three studies using samples of people in romantic relationships were conducted to create a new individual difference measure of partner strengths in couples. The 2 perceptions of partner strengths included (1) appreciation of their use and effectiveness and (2) recognition of costs associated with their use. Factor analyses supported 2-factors and we found that greater appreciation of partner strengths predicted greater relationship satisfaction, commitment, investment, intimacy, self-expansion, and support for goal pursuit; recognizing significant costs with partner strengths was inversely related to several outcomes. Using a 1-week daily diary, we found that appreciation of partner strength use and recognition of costs associated with these strengths predicted daily relationship satisfaction and whether basic psychological needs were met within the relationship. The explanatory power of partner strength perceptions could not be explained by the actual character strengths or Big Five personality traits of partners, support for positive self-disclosures (capitalization), or gratitude for relationship partners. Finally, we found that the relational consequences of partner strength perceptions were not just "in the head" of the perceiver-influencing partner relational outcomes. This research program provides evidence for the use of a new measure of how strengths are perceived to better understand romantic couples and aspirational targets in clinical interventions. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

We interact daily with computers that appear and behave like humans. Some researchers propose that people apply the same social norms to computers as they do to humans, suggesting that social psychological knowledge can be applied to our interactions with computers. In contrast, theories of human–automation interaction postulate that humans respond to machines in unique and specific ways. We believe that anthropomorphism—the degree to which an agent exhibits human characteristics—is the critical variable that may resolve this apparent contradiction across the formation, violation, and repair stages of trust. Three experiments were designed to examine these opposing viewpoints by varying the appearance and behavior of automated agents. Participants received advice that deteriorated gradually in reliability from a computer, avatar, or human agent. Our results showed (a) that anthropomorphic agents were associated with greater trust resilience , a higher resistance to breakdowns in trust; (b) that these effects were magnified by greater uncertainty; and c) that incorporating human-like trust repair behavior largely erased differences between the agents. Automation anthropomorphism is therefore a critical variable that should be carefully incorporated into any general theory of human–agent trust as well as novel automation design., (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Although a large body of research shows that general cognitive ability is heritable and stable in young adults, there is recent evidence that fluid intelligence can be heightened with cognitive training. Many researchers, however, have questioned the methodology of the cognitive-training studies reporting improvements in fluid intelligence: specifically, the role of placebo effects. We designed a procedure to intentionally induce a placebo effect via overt recruitment in an effort to evaluate the role of placebo effects in fluid intelligence gains from cognitive training. Individuals who self-selected into the placebo group by responding to a suggestive flyer showed improvements after a single, 1-h session of cognitive training that equates to a 5- to 10-point increase on a standard IQ test. Controls responding to a nonsuggestive flyer showed no improvement. These findings provide an alternative explanation for effects observed in the cognitive-training literature and the brain-training industry, revealing the need to account for confounds in future research.

Researchers and clinicians assume a strong, positive correlation between anxiety symptoms and functional impairment. That assumption may be well-justified since diagnostic criteria typically include functional impairment. Still, the relationship remains largely unavailable in any systematic review. Our aim with this paper was to provide empirical evidence for this assumed relationship and to document the observed correlations between anxiety symptom measures and functional impairment measures. Correlations existed for symptoms of six anxiety disorders (Panic Disorder, Agoraphobia, Social Anxiety Disorder, Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Obsessive Compulsive Disorder) across four functional domains (global, social, occupational, and physical). Overall, the mean of 497 correlations across all disorders and functional domains was modest (r=.34); since the variability between disorders and functional domains tended to be rather large, we explored these correlations further. We presented these results and the potential explanations for unexpected findings along with the clinical and research implications., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Extraversion--one of the Big 5 personality factors--correlates negatively with vigilance, but most studies focus on performance outcomes and not the performance process. Previous research has shown that transcranial Doppler sonography (TCD), which measures cerebral blood flow velocity (CBFV), can be used to examine resource allocation strategies during vigilance performance. Hence, this study was designed to assess the attentional resource allocation strategies of introverts and extraverts using the CBFV measure. Twelve extroverts and 13 introverts monitored a 60-min vigilance task for a critical signal--the absence of a line on a five-circle array. The results revealed an overall performance decrement that was not modulated by extraversion. We observed an interaction between extraversion and time; CBFV declined in the introversion group, but not in the extraversion group. Additionally, an interaction between cerebral hemisphere and personality revealed that extraverts were recruiting resources from both the left and right cerebral hemispheres, while introverts only recruited resources from the right hemisphere. The results suggest that extraverts can allocate compensatory effort to mask performance differences. We discuss the theoretical and practical implications of these findings and offer future research directions that may help us understand these effects.

This study developed and evaluated a brief training program for grant reviewers that aimed to increase inter-rater reliability, rating scale knowledge, and effort to read the grant review criteria. Enhancing reviewer training may improve the reliability and accuracy of research grant proposal scoring and funding recommendations. Seventy-five Public Health professors from U.S. research universities watched the training video we produced and assigned scores to the National Institutes of Health scoring criteria proposal summary descriptions. For both novice and experienced reviewers, the training video increased scoring accuracy (the percentage of scores that reflect the true rating scale values), inter-rater reliability, and the amount of time reading the review criteria compared to the no video condition. The increase in reliability for experienced reviewers is notable because it is commonly assumed that reviewers--especially those with experience--have good understanding of the grant review rating scale. The findings suggest that both experienced and novice reviewers who had not received the type of training developed in this study may not have appropriate understanding of the definitions and meaning for each value of the rating scale and that experienced reviewers may overestimate their knowledge of the rating scale. The results underscore the benefits of and need for specialized peer reviewer training.

Disruptions to daily living, inflammation, and astrogliosis are characteristics of Alzheimer's disease. Thus, circadian rhythms, nest construction, IL-1β and TNF-α, and glial fibrillary acidic protein (GFAP) were examined in a mouse model developed to model late-onset Alzheimer's disease-the most common form of the disease. Mice carrying both the mutated human AβPP transgene found in the CRND8 mouse and the human apolipoprotein E ε4 allele (CRND8/E4) were compared with CRND8 mice and wildtype (WT) mice. Circadian rhythms were evaluated by wheel-running behavior. Activity of daily living was measured by nest construction. This study then examined mRNA levels of the inflammatory cytokines IL-1β and TNF-α as well as protein levels of GFAP. Behavioral outcomes were then correlated with cytokines and GFAP. Compared to WT controls, both CRND8 and CRND8/E4 mice showed significantly more frequent, but shorter, bouts of activity. In the three groups, the CRND8/E4 mice had intermediate disruptions in circadian rhythms. Both CRND8/E4 mice and CRND8 mice showed significant impairments in nesting behavior compared to WTs. While CRND8 mice expressed significantly increased IL-1β and GFAP expression compared to WT controls, CRND8/E4 mice expressed intermediate IL-1β and GFAP levels. Significant correlations between IL-1β, GFAP, and behavior were observed. These data are congruent with other studies showing that human ApoE ε4 is protective early in life in transgenic mice modeling Alzheimer's disease.

A growing literature attests to deficits in social and romantic life quality in people with elevated social anxiety, but no research to date has explored how intense intimate encounters influence social anxiety symptoms. This study investigated whether the presence and quality of sexual activity on a given day predicted less social anxiety and negative cognitions on a subsequent day. We also explored whether the benefits of sexual activity would be stronger for more socially anxious individuals. Over 21 days, 172 undergraduate students described the presence and quality of sexual activity, social anxiety symptoms, and use of social comparisons on the day in question. Time-lagged analyses determined that being sexually active on one day was related to less social anxiety symptoms and the generation of fewer negative social comparisons the next day. Furthermore, more intense experiences of pleasure and connectedness during sex predicted greater reductions in social anxiety the next day for people high in trait social anxiety, compared to those low in trait social anxiety. These results were similar regardless of whether sex occurred in the context of romantic relationships or on weekdays versus weekends. The results suggest that sexual activity, particularly when pleasurable and intimate, may mitigate some of the social anxiety and negative comparisons frequently experienced by people with high trait social anxiety.

Nonsuicidal self-injury is especially common in adolescents and young adults. Self-injury may be related to shame or guilt--two moral emotions--as these differentially predict other maladaptive behaviors. Using a college sample, we examined not only how shame-proneness, guilt-proneness, and internalizing emotional tendencies related to self-injury, but also whether these moral emotions moderate the relation between internalizing tendencies and self-injury. High shame-proneness was associated with higher frequencies of self-injury. High guilt-proneness was associated with less self-injury, although this effect was mitigated at higher levels of internalizing tendencies. These results suggest shame-proneness is a risk factor for self-injury, while guilt-proneness is protective., (© 2013 The American Association of Suicidology.)

Recent acceptance- and mindfulness-based cognitive-behavioral interventions explicitly target the clarification and commitment to a purpose in life. Yet, scant empirical evidence exists on the value of purpose as a mechanism relevant to psychopathology or well-being. The present research explored daily (within-person) fluctuations in purposeful pursuits and well-being in a community sample of 84 adults with (n = 41) and without (n = 43) the generalized subtype of social anxiety disorder (SAD). After completing an idiographic measure of purpose in life, participants monitored their effort and progress toward this purpose, along with their well-being each day. Across 2 weeks of daily reports, we found that healthy controls reported increased self-esteem, meaning in life, positive emotions, and decreased negative emotions. People with SAD experienced substantial boosts in well-being indicators on days characterized by significant effort or progress toward their life purpose. We found no evidence for the reverse direction (with well-being boosting the amount of effort or progress that people with SAD devote to their purpose), and effects could not be attributed to comorbid mood or anxiety disorders. Results provide evidence for how commitment to a purpose in life enriches the daily existence of people with SAD. The current study supports principles that underlie what many clinicians are already doing with clients for SAD.

Extending prior work on social anxiety and positivity deficits, we examined whether individual differences in social anxiety alter the ability to share and respond to the good news of romantic partners (i.e., capitalization support) and how this influences romantic relationship satisfaction and commitment. In this study of 174 heterosexual couples (average age of 21.5 with 58.3% identifying as Caucasian), greater social anxiety was associated with the provision and receipt of less supportive responses to shared positive events as measured by trait questionnaires, partner reports, and behavioral observations in the laboratory. In longitudinal analyses, individuals in romantic relationships with socially anxious partners who experienced inadequate capitalization support were more likely to terminate their relationship and report a decline in relationship quality six months later. As evidence of construct specificity, social anxiety effects were independent of depressive symptoms. Taken together, social anxiety influenced a person's ability to receive and provide support for shared positive events; these deficits had adverse romantic consequences. Researchers and clinicians may better understand social anxiety by exploring a wider range of interpersonal contexts and positive constructs. The addition of capitalization support to the social anxiety literature offers new insights into interpersonal approaches and treatments., (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Despite the increased attention that researchers have paid to social anxiety disorder (SAD), compared with other anxiety and mood disorders, relatively little is known about the emotional and social factors that distinguish individuals who meet diagnostic criteria from those who do not. In this study, participants with and without a diagnosis of SAD (generalized subtype) described their daily face-to-face social interactions for 2 weeks using handheld computers. We hypothesized that, compared with healthy controls, individuals diagnosed with SAD would experience fewer positive emotions, rely more on experiential avoidance (of anxiety), and have greater self-control depletion (feeling mentally and physically exhausted after socializing), after accounting for social anxiety, negative emotions, and feelings of belonging during social interactions. We found that compared with healthy controls, individuals with SAD experienced weaker positive emotions and greater experiential avoidance, but there were no differences in self-control depletion between groups. Moreover, the differences we found could not be attributed to comorbid anxiety or depressive disorders. Our results suggest that negative emotions alone do not fully distinguish normal from pathological social anxiety, and that assessing social anxiety disorder should include impairments in positive emotional experiences and dysfunctional emotion regulation (in the form of experiential avoidance) in social situations., (PsycINFO Database Record (c) 2013 APA, all rights reserved.)

Prior research suggests that rumination and chronic negative emotions serve to maintain emotional disorders. However, some evidence suggests that pondering the nature and meaning of negative experiences can be adaptive. To better understand the function of this dimension of rumination, we studied the use of this strategy in response to negative emotions as they unfold from day to day in veterans with (n=27) and without (n=27) post traumatic stress disorder (PTSD). For two weeks, veterans completed daily questions about when they experienced a bad mood and how often they used rumination to feel differently. It was hypothesized that rumination would attenuate negative emotional reactions in veterans without PTSD, but that rigid, intense negative emotions would persist in veterans with PTSD. Using multilevel modeling, we found that on the same day, rumination was positively associated with negative affect. Because covariation fails to address directionality, we also examined lagged effects from one occasion to the next. For veterans without PTSD, more frequent use of rumination predicted less intense negative affect the next day; there was no support for a model with negative affect predicting rumination the next day. For veterans with PTSD, the prior day's intensity of negative affect was the only predictor of intensity of negative affect the next day. Results support the value of distinguishing within-day and across day effects, and the presence of PTSD, to clarify contexts when rumination is adaptive., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Curious people seek knowledge and new experiences. In 3 studies, we examined whether, when, and how curiosity contributes to positive social outcomes between unacquainted strangers. Study 1 (98 college students) showed that curious people expect to generate closeness during intimate conversations but not during small talk; less curious people anticipated poor outcomes in both situations. We hypothesized that curious people underestimate their ability to bond with unacquainted strangers during mundane conversations. Studies 2 (90 college students) and 3 (106 college students) showed that curious people felt close to partners during intimate and small-talk conversations; less curious people only felt close when the situation offered relationship-building exercises. Surprise at the pleasure felt during this novel, uncertain situation partially mediated the benefits linked to curiosity. We found evidence of slight asymmetry between self and partner reactions. Results could not be attributed to physical attraction or positive affect. Collectively, results suggest that positive social interactions benefit from an open and curious mind-set., (© 2010 The Authors. Journal of Personality © 2011, Wiley Periodicals, Inc.)

This special issue of Journal of Personality, composed of eight original articles, attends to the intersection of intrapersonal and interpersonal processes. Articles adopt a contextual approach to personality with attention to the need to belong (and the lack thereof), self-presentation concerns and styles, sexuality, curiosity, self-regulatory strength and strategies, and dynamic methodologies and analyses to study people within relationships. In this introduction, we offer challenges and aspirational goals for personality science. In particular, we discuss the importance of context when conceptualizing and studying personality, the seduction of innovative methodologies and analytic procedures, and the value of focusing on people and heterogeneity in groups instead of simply variables. We hope that this collection of articles deepens personality science and reminds readers that to truly understand human beings, they cannot be divorced from their social milieu., (© 2011 The Authors. Journal of Personality © 2011, Wiley Periodicals, Inc.)

Diminished positive experiences and events might be part of the phenomenology of social anxiety; however, much of this research is cross-sectional by design, limiting our understanding of the everyday lives of socially anxious people. Sexuality is a primary source of positive experiences. We theorized that people with elevated social anxiety would have relatively less satisfying sexual experiences compared to those who were not anxious. For 21 days, 150 college students described their daily sexual episodes. Social anxiety was negatively related to the pleasure and feelings of connectedness experienced when sexually intimate. The relationship between social anxiety and the amount of sexual contact differed between men and women-it was negative for women and negligible for men. Being in a close, intimate relationship enhanced the feelings of connectedness during sexual episodes for only individuals low in social anxiety. Depressive symptoms were negatively related to the amount of sexual contact, and the pleasure and feelings of connectedness experienced when sexually intimate. Controlling for depressive symptoms did not meaningfully change the social anxiety effects on daily sexuality. Our findings suggest that fulfilling sexual activity is often compromised by social anxiety., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Background: Prescription of resistance training (RT) exercises is an essential aspect of management for knee osteoarthritis (OA). However, whether patients with knee OA who are randomly assigned to receive RT simply substitute RT for other modes of physical activity remains unclear., Objective: The aim of this study was to determine the effect of a structured RT intervention on overall levels of moderate- and vigorous-intensity physical activity (MVPA) in patients with early-onset knee OA. The study compared patients with early-onset OA who participated in an RT program, those who participated in a self-management (SM) program, and those who participated in both RT and SM. Because participants randomly assigned to receive the RT intervention may simply switch activity modes, resulting in little net effect, we assessed total MVPA in addition to tracking changes in strength (force-generating capacity)., Design and Intervention: This study was a randomized controlled trial comparing the effectiveness of SM alone, RT alone, and combined RT+SM on MVPA in patients with early OA of the knee., Setting: The study was conducted on a university campus, with patient recruitment from the local community., Participants: The participants in this study were 171 patients (74% women, 26% men) with knee OA. They had a mean age of 55.1 (SD=7.1) years, a mean body mass index of 27.6 (SD=4.2) kg/m(2), and radiographic status of grade II OA (and no higher) in at least one knee, as defined by the Kellgren and Lawrence classification. They wore an accelerometer while awake (X=14.2 [SD=2.2] hours) for 5 to 7 contiguous days (X=6.8 [SD=0.5] days) at baseline and at 3 and 9 months of intervention., Results: The participants engaged in MVPA a mean of 26.2 (SD=19.3) minutes per day at baseline. Both groups significantly increased their MVPA from baseline to 3 months (RT group by 18% [effect size (d)=0.26]; SM group by 22% [effect size (d)=0.25]), but only the RT group sustained those changes at 9 months (RT group maintained a 10% increase [effect size (d)=0.15]; SM group maintained a 2% increase [effect size (d)=0.03]). A significant group x time interaction for MVPA indicated that the RT group maintained higher MVPA levels than the SM group., Limitations: Lack of direct measures of energy expenditure and physical function was a limitation of the study., Conclusions: Patients with early-onset OA of the knee can engage in an RT program without sacrificing their overall MVPA levels. These results support the value of RT for management of knee OA.

Objective: To assess the relative effectiveness of combining self-management and strength training for improving functional outcomes in patients with early knee osteoarthritis., Methods: We conducted a randomized intervention trial lasting 24 months at an academic medical center. Community-dwelling middle-aged adults (n = 273) ages 35-64 years with knee osteoarthritis, pain, and self-reported physical disability completed a strength training program, a self-management program, or a combined program. Outcomes included 5 physical function tests (leg press, range of motion, work capacity, balance, and stair climbing) and 2 self-reported measures of pain and disability., Results: A total of 201 participants (73.6%) completed the 2-year trial. Overall, compliance was modest for the strength training (55.8%), self-management (69.1%), and combined (59.6%) programs. The 3 groups showed a significant and large increase from pre- to posttreatment in all of the physical functioning measures, including leg press (d = 0.85), range of motion (d = 1.00), work capacity (d = 0.60), balance (d = 0.59), and stair climbing (d = 0.59). Additionally, all 3 groups showed decreased self-reported pain (d = -0.51) and disability (d = -0.55). There were no significant differences among the groups., Conclusion: Middle-aged, sedentary persons with mild early knee osteoarthritis benefited from strength training, self-management, and the combination program. These results suggest that both strength training and self-management are suitable treatments for the early onset of knee osteoarthritis in middle-aged adults. Self-management alone may offer the least burdensome treatment for early osteoarthritis.

Objective: Supportive close relationships are important for health. Mutuality, the reciprocal sharing of thoughts and feelings in close relationships, is linked with better outcomes for patients with rheumatoid arthritis (RA) in cross-sectional data. Hypothesizing that mutuality has a beneficial impact on inflammation, we tested potentially causal relations of couple mutuality with erythrocyte sedimentation rate (ESR) in prospective data., Methods: Female patients with RA (n = 70; mean age 57 years, mean RA disease duration 5 years) completed questionnaires at baseline, 6 months, and 12 months, including measures of mutuality, RA flares, and negative affect. ESR laboratory values available near questionnaire dates were collected from medical charts. Using regression, we examined cross-lagged effects of mutuality and ESR over the two 6-month time spans (baseline to 6 months, 6 months to 12 months). We anticipated that mutuality would exert lagged inverse effects on subsequent ESR levels, and that ESR would have no effect on subsequent mutuality levels., Results: After controlling for lagged effects of earlier inflammation, disease-modifying antirheumatic drugs, antiinflammatory drugs, RA flares, and negative affect, mutuality's lagged inverse effects over both time spans accounted for unique variance in subsequent levels of ESR, explaining 9% at 6 months and 12.5% at 12 months. Concomitantly, earlier ESR had no effect on subsequent mutuality., Conclusion: Patients with RA reporting more mutuality had less inflammation at subsequent time points, but inflammation had no effect on subsequent reports of mutuality. This suggests that mutuality exerts a beneficial effect on inflammation. Clinical implications and potential applications are discussed.

Little is known about people with social anxiety disorder (SAD) who are not behaviorally inhibited. To advance knowledge on phenomenology, functional impairment, and treatment seeking, we investigated whether engaging in risk-prone behaviors accounts for heterogeneous outcomes in people with SAD. Using the National Comorbidity Survey-Replication (NCS-R) dataset, our analyses focused on people with current (N = 679) or lifetime (N = 1143) SAD diagnoses. Using latent class analysis on NCS-R risk-prone behavior items, results supported two SAD classes: (1) a pattern of behavioral inhibition and risk aversion and (2) an atypical pattern of high anger and aggression, and moderate/high sexual impulsivity and substance use problems. An atypical pattern of risk-prone behaviors was associated with greater functional impairment, less education and income, younger age, and particular psychiatric comorbidities. Results could not be subsumed by the severity, type, or number of social fears, or comorbid anxiety or mood disorders. Conclusions about the nature, course, and treatment of SAD may be compromised by not attending to heterogeneity in behavior patterns.

Anxiety disorders and externalizing problems are both associated with substance use disorders. However, the nature of this relationship remains unclear. To examine whether presence of an anxiety disorder changes the association between externalizing problems (conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder) and substance use disorders, we analyzed data from the National Comorbidity Survey-Replication, which is based on a nationally representative sample of 9282 English-speaking adults. Presence of externalizing problems was associated with an increased odds for alcohol abuse (OR: 6.7, CI: 5.6-8.1), alcohol dependence (OR: 7.6, CI: 5.9-9.6), substance abuse (OR: 9.9, CI: 8.1-12.2), and substance dependence (OR: 13.1, CI: 9.6-17.8). Similarly, anxiety disorders were associated with increased odds for substance use disorders. The highest association was found between post-traumatic stress disorder and substance use disorder (OR: 9.2, CI: 5.4-15.5). Individuals who met diagnostic criteria for an anxiety disorder and externalizing problems showed consistently and significantly lower odds for substance use problems than subjects with externalizing problems without a comorbid anxiety disorder. The results suggest that presence of any anxiety disorder reduces the association between externalizing problems and substance use disorders, possibly because the fear of bodily symptoms prevents individuals with externalizing problems from engaging in drug-seeking behaviors.

Outcomes in depression treatment research include both changes in symptom severity and functional impairment. Symptom measures tend to be the standard outcome but we argue that there are benefits to considering functional outcomes. An exhaustive literature review shows that the relationship between symptoms and functioning remains unexpectedly weak and often bidirectional. Changes in functioning often lag symptom changes. As a result, functional outcomes might offer depression researchers more critical feedback and better guidance when studying depression treatment outcomes. The paper presents a case for the necessity of both functional and symptom outcomes in depression treatment research by addressing three aims-1) review the research relating symptoms and functioning, 2) provide a rationale for measuring both outcomes, and 3) discuss potential artifacts in measuring functional outcomes. The three aims are supported by an empirical review of the treatment outcome and epidemiological literatures.

Purpose: To assess the relative importance of several measurement facets including respondent (patient or clinicians), item (functional domains), and administration (pre- and postrehabilitation) on assessing perceived functional outcomes in vision rehabilitation., Methods: A convenience sample of VA veterans were assessed with a self-report and clinician rated perceived functional ability instrument before and after rehabilitation services. The items were analyzed using a Rasch model to ensure that both versions fit the restrictive model well enough to be directly compared. A second analysis using a generalizability theory model assessed the relative importance of each measurement facet., Results: The Rasch model supported the equivalence of the two different versions of the outcome instrument. The generalizability theory model showed that administration accounted for the majority of the variance and that respondents and items contributed very little to perceived functional assessment., Conclusions: The results support the conclusion that both clinical ratings and patient self-reported perceived functional ability ratings provide relative equivalent values in blind and low-vision rehabilitation settings. The relative importance of administration time in predicting scores may support the general conclusion that rehabilitation produces the largest relative changes in perceived functional ability and ought to shift researchers' focus away from the subtleties of instrument development and more toward assessing program and individual outcomes. Finally, these findings suggest that there is little promise in modeling individual differences to account for perceived functional ability changes because of rehabilitation.

Researchers interested in measuring individual differences in affective style via asymmetries in frontal brain activity have depended almost exclusively upon the resting state for EEG recording. This reflects an implicit conceptualization of affective style as a response predisposition that is manifest in frontal EEG asymmetry, with the goal to describe individuals in terms of their general approach or withdrawal tendencies. Alternatively, the response capability conceptualization seeks to identify individual capabilities for approach versus withdrawal responses during emotionally salient events. The capability approach confers a variety of advantages to the study of affective style and personality, and suggests new possibilities for the approach/withdrawal motivational model of frontal EEG asymmetry and emotion. Logical as well as empirical arguments supportive of this conclusion are presented.

Evidence-based policy is being encouraged in all areas of public service ( Black 2001 ). Unprecedented federal legislation reflects a faith in science "as a force for improved public policy" ( Feuer et al. 2002 ). The objective of evidence-based policy is to use scientific research to drive decision making. Thus, the link between social science research and public policy seems to be a natural one. The purpose of this chapter is to address how psychological science in general, and clinical psychology in particular, can be of use to public policy makers. We discuss how psychological science can be relevant and applicable to informing policy, and we describe the role clinical scientists might play in generating, disseminating, and implementing that information. We also note distinct limitations on the usefulness of psychological research in driving public policy. We discuss some pitfalls and recommend areas where clinical psychology might best serve public policy.

Unlabelled: The Roland-Morris Disability Scale has been shown to be a reliable and valid measure of disability in persons with chronic pain. A short form with psychometric properties similar to the full scale would have numerous benefits, including decreased patient assessment burden and scoring time. On the basis of data obtained from 993 individuals with chronic pain screened for admission to a multidisciplinary pain management program, an 11-item short form of the Roland scale was developed using procedures and models from item response theory. This short form was found to be a good predictor of the 24-item parent scale and a previously published 18-item short form. The 11-item scale also demonstrated concurrent validity with measures of pain intensity and depression. Item content reflected limitations in specific functional behaviors., Perspective: Brief measures of important pain-related variables can be created using item response theory (IRT). In this study, a reliable and valid 11-item version of the Roland-Morris Disability Scale was created using IRT. Clinicians and researchers might consider using this scale when patient or subject assessment burden is an issue.

The purpose of this study was to examine the association of psychosocial and other variables to pulmonary function over four months. Thirty-two patients with asthma kept daily records of pulmonary function and psychosocial variables for an average of 140 days. Data on other potential covariates of pulmonary function, as assessed by peak flow meters, were also collected (e.g., allergen exposure). Sixteen subjects (50%) had significant associations between pulmonary function and psychosocial variables. Between-subjects analyses showed small but significant associations between pulmonary function and other variables. These results confirmed previous reports of individual variability in the association of psychosocial variables with pulmonary function.

Missing data constitute a common but widely underappreciated problem in both cross-sectional and longitudinal research. Furthermore, both the gravity of the problems associated with missing data and the availability of the applicable solutions are greatly increased by the use of multivariate analysis. The most common approaches to dealing with missing data are reviewed, such as data deletion and data imputation, and their relative merits and limitations are discussed. One particular form of data imputation based on latent variable modeling, which we call Multivariate Imputation, is highlighted as holding great promise for dealing with missing data in the context of multivariate analysis. The recent theoretical extension of latent variable modeling to growth curve analysis also permitted us to extend the same kind of solution to the problem of missing data in longitudinal studies. Data simulations are used to compare the results of multivariate imputation to other common approaches to missing data.