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The COVID-19 pandemic created a complex psychological environment for Americans. In this study, 450 MTurk workers completed measures of sociodemographic characteristics, perceived risk for COVID-19, general perceived vulnerability to disease, intolerance of uncertainty, and psychological flexibility. These variables were used to predict COVID-19 preventive health behaviors (PPE use), psychological distress, and physical symptoms. The surveys were completed between April 9, 2020 and April 18, 2020 which is a period that corresponded to the first 2–3 weeks of lockdown for most participants. A demographically diverse sample of participants was recruited. A substantial number of participants reported a reduction employment status and 69% were in self-isolation. Participants reported a high degree of perceived vulnerability to COVID-19. PPE mask wearing was variable: 16% “not at all,” 20% “some of the time,” 42% “a good part of the time,” and 26 “most of the time.” Using clinical cutoff on the post-trauma scale, 70% of the sample would be considered to have symptoms consistent with PTSD. Physical symptom reporting was also high. Intolerance of uncertainty and psychological inflexibility were significant predictors of psychological distress and physical symptoms. Psychological flexibility moderated the relationship between intolerance of uncertainty and psychological distress/physical symptoms. The relationship between intolerance of uncertainty and psychological distress/physical symptoms was stronger among participants with lower levels of psychological flexibility. These findings indicate psychological flexibility can reduce distress associated with COVID-19. Additionally, these results support the workability of the Unified Flexibility and Mindfulness Model as a framework for studying health behavior.

Functional Analytic Psychotherapy (FAP) is a contextual behavioral therapy that targets specific ideographic behaviors related to interpersonal functioning and intimacy. There is a scarcity of measures specifically focused on behavioral measurement of intimacy as well as limited studies that examine intimacy in obsessive-compulsive and related disorders (OCRDs). Leonard and colleagues (2014) created the Functional Analytic Psychotherapy Intimacy Scale (FAPIS). The purpose of this study was to investigate the validity of the FAPIS in evaluating those with OCRDs. The FAPIS and other measures of intimacy were administered to 549 nonreferred adults endorsing OCRD symptoms. Several confirmatory factor analyses were conducted to assess the best fitting factor structure, and convergent validity and divergent validity were also assessed. Given the psychometric properties of the FAPIS in this sample, future research may be helpful in assessing if the FAPIS would be beneficial in measuring change related to intimacy when working with people with OCRDs.

Objectives Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals. Methods Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables. Results Twenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component. Conclusions Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators. Electronic supplementary material The online version of this article (10.1007/s12671-020-01342-5) contains supplementary material, which is available to authorized users.

The COVID-19 pandemic has prompted a growing recommendation for social distancing and using personal protective equipment (PPE) to help mitigate the virus transmission. Previous studies have shown promising relationships between perceived susceptibility to COVID-19, mindfulness-related variables, and COVID-19 health protective behaviors (social distancing and PPE use). In this longitudinal study, the variables were measured across a two-month interval during the earlier phase of the pandemic in June (Time 1) and August (Time 2), 2020. The results from 151 matched USA MTurk participants indicated that the perceived susceptibility to COVID-19 did not significantly predict the health protective behaviors. For mindfulness, nonreactivity was positively related to PPE use while nonjudgement was negatively related to PPE use. Accordingly, mindfulness promotion messages could be a way to increase the likelihood of people performing health protective behaviors to better constrain the COVID-19 outbreak.

The COVID-19 pandemic created a complex psychological environment for persons in America. A total of 450 USA MTurk workers completed measures of: (a) basic demographic characteristics; (b) health risk factors for COVID-19; (c) perceived susceptibility variables related to COVID-19; (d) COVID-19 preventive health behaviors; and (e) distress, physical symptoms, and quality of life measures. The surveys were completed between April 9, 2020 and April 18, 2020. This recruitment period corresponded to the first 2-3 weeks of lockdown in most of the USA. Follow-up surveys were completed by 151 of the USA participants between June 19, 2020 and July 11, 2020 (approximately 2 months after the first measurement). These data permit evaluation of relationships among demographic variables, COVID-19 stress and coping, COVID-19 preventive health behavior, and the role of mindfulness as a possible moderator of distress as well as a predictor of preventive health behavior. The availability of follow-up data permit longitudinal analyses that provide a stronger basis for causal inference.

The COVID-19 pandemic combined with inconsistent governmental and public health recommendations, media communications emphasizing threat, and widespread lockdowns created a complex psychological environment for Americans. In this study, 450 MTurk workers completed measures of (a) risk for COVID-19, (b) perceived vulnerability to disease, (c) intolerance of uncertainty, (d) mindfulness, (e) COVID-19 preventive health behaviors, (f) post-Trauma symptoms, and (g) stress related physical symptoms. The surveys were completed between April 9, 2020 and April 18, 2020 which is a period that corresponded to the first 2-3 weeks of lockdown for most participants.A substantial number of participants reported a reduction employment status and 69% were in self-isolation. The participants reported a high degree of perceived vulnerability with 68% indicating they felt there was a 50/50 chance or greater they would contract COVID-19. Mask wearing was variable: 16% “not at all,” 20% “some of the time,” 42% “a good part of the time,” and 26% “most of the time.” Using clinical cutoff on the post-trauma scale, 70% of the sample would be considered to have symptoms consistent with PTSD. The mean level of physical symptoms was significantly (p < .001) and substantially higher (d = 1.46) than norms.PPE use was positively associated with level of education and mindfulness nonreactivity and negatively associated with age, having a current medical condition, and mindfulness nonjudgment. Post trauma and physical health symptoms were strongly predicted by susceptibility variables and intolerance of uncertainty.HighlightsCOVID-19 created a complex psychological environment for Americans due to threat exposure combined with contradictory communications from government and media.In a survey of 450 Americans, 68% reported that there was a 50/50 chance of greater they would contract COVID-19 and 70% of participants reported symptoms that met criteria for PTSD.Mask wearing was variable with only 26% reporting use “most of the time.”Participants who reported: older age, having one or mode medical conditions, less educational attainment, and less judgmental attitudes about their own thinking reported lower PPE use.Intolerance of uncertainty and perceived susceptibility were associated with higher PTSD symptoms.Mindfulness awareness and being judgmental attitudes about thinking were associated with lower PTSD symptoms.

The present study examined the different types of stressors experienced by adults of different ages, their coping strategies, and positive/negative affect. A mediation hypothesis of coping strategies was tested on the relationships between age and positive/negative affect. One-hundred and ninety-six community-dwelling adults (age range 18–89 years) reported the most stressful situation they experienced in the past month and coping strategies. Levels of positive and negative affect in the past month were also measured. Content analysis revealed age differences in different types of stressors adults reported. Three types of coping strategies were found: problem-focused, positive emotion-focused, and negative emotion-focused coping. Older adults were less likely than younger adults to use problem-focused coping and reported lower levels of positive affect. Path analysis supported the mediation hypothesis, showing that problem-focused coping mediated the relationship between age and positive affect. Implications are discussed on the importance of promoting problem-focused coping among older adults.

Acceptance and chronic pain is an emerging topic both for research and intervention. Initial studies have demonstrated that acceptance is correlated with higher quality of daily emotional, social, and physical functioning in chronic pain populations. The purpose of the present study was to clarify the nature of the relationship between acceptance, appraisals that are relevant to chronic pain (i.e., control and catastrophizing), and coping among migraine headache sufferers. Seventy four participants with migraine headaches completed self report measures assessing appraisal, coping strategies, acceptance, and pain related disability. Sixty three participants also completed a 28-day daily dairy assessing headache activity, catastrophizing, control, acceptance, and coping strategies. Hierarchical regression and multilevel modeling were used to examine the relations between these variables. Results indicated that higher levels of pain-related acceptance were associated with lower levels of catastrophizing and pain-related interference, and increased perceived control. Participants who endorsed higher levels of pain-related acceptance also reported engaging in a higher level of activity and indicated they used fewer coping strategies on a daily basis. Acceptance continues to show promise as a way of viewing pain that lessens the detrimental impact of certain types of thoughts (i.e., catastrophizing), and leads to increased participation in daily life.

Abstract. Although band and spot electrodes have been compared in prior research, they have not been evaluated (a) at identical anatomical locations, (b) during a single laboratory session, (c) with measures taken in close temporal proximity, (d) using a single impedance cardiograph unit, or (e) using sufficiently powerful statistical tests. Thirty-one healthy young adults completed a psychophysiological assessment which consisted of baseline, mental arithmetic stressor, and recovery conditions. Data from spot and band electrodes were collected by alternating between electrode types every minute of the experiment. Correlations between spot and band electrodes at absolute levels of all cardiovascular measures (cardiac output, impedance derivative, basal impedance level, Heather index, heart rate, left ventricular ejection time, pre-ejection period, stroke volume) were of high magnitude (ravg = .78), while the correlations for difference scores were lower (ravg = .50). Analyses of mean levels indicated spot electrodes yielded significantly lower values for the impedance derivative, Heather index, and basal impedance, and higher values for cardiac output and stroke volume, than band electrodes. The advantages and disadvantages associated with spot and band electrode configurations, as well as their use in ambulatory recording, are discussed.

The pathogenic processes responsible for cardiovascular disease have their origins in childhood. Although children’s measures of heart rate and blood pressure have been found to be reliable, the reliability of impedance cardiography derived measures have not been evaluated. Thirty-three children, ages 8‐11 participated in two sessions. Stressors included serial subtraction, isometric handgrip, and mirror-image tracing. Results indicated the impedance measures showed moderately high temporal stability ~average scores ravg 5 .74; difference scores ravg 5 .53! and intertask consistency ~average scores ravg 5 .78; difference scores ravg 5 .53!. Blood pressure demonstrated the lowest reliability; Heather index, preejection period, and stroke volume demonstrated the highest. These findings suggest children’s cardiovascular reactivity to laboratory stressors can be reliably and consistently assessed using impedance cardiography.

The purpose of this study was to investigate how migraine headache sufferers and headache-free controls differ in their appraisal and coping responses to a cognitive (mental arithmetic) and a physical (cold pressor) laboratory stressor. Fifty-two women (26 migraine headache and 26 controls) completed the study. Results indicated that migraine sufferers rated the cold pressor task as significantly more painful compared to headache-free participants. Migraine headache sufferers also reported more wishful thinking and self-criticism in managing the mental arithmetic stressor. In addition, migraine participants reported the use of more social withdrawal and catastrophizing in managing stress and pain outside of the laboratory.

Background An estimated up to 7% of high-risk cardiac surgery patients return to the operating room for bleeding. Aprotinin was used extensively as an antifibrinolytic agent in cardiac surgery patients for over 15 years and it showed efficacy in reducing bleeding. Aprotinin was removed from the market by the U.S. Food and Drug Administration after a large prospective, randomized clinical trial documented an increased mortality risk associated with the drug. Further debate arose when a meta-analysis of 211 randomized controlled trials showed no risk of renal failure or death associated with aprotinin. However, only patients with normal kidney function have been studied. Methods In this study, we look at a single center clinical trial using patients with varying degrees of baseline kidney function to answer the question: Does aprotinin increase odds of death given varying levels of preoperative kidney dysfunction? Results Based on our model, aprotinin use was associated with a 3.8-fold increase in odds of death one year later compared to no aprotinin use with p-value = 0.0018, regardless of level of preoperative kidney dysfunction after adjusting for other perioperative variables. Conclusions Lessons learned from our experience using aprotinin in the perioperative setting as an antifibrinolytic during open cardiac surgery should guide us in testing future antifibrinolytic drugs for not only efficacy of preventing bleeding, but for overall safety to the whole organism using long-term clinical outcome studies, including those with varying degree of baseline kidney function.

In this paper two research studies by Eells (2010) and Edwards (2010) evaluating case formulation and therapist responsiveness are summarized and critically evaluated. The central themes abstracted from these studies are subsequently articulated and integrated with existing research on the philosophical and theoretical competencies, clinical competencies, and quantitative competencies needed for effective case formulation. More specifically, I introduce and evaluate the work of Edwards and Eells in terms of a behavioral model of case formulation that is based on four general principles: functionalism; empiricism, cognitive-behavioral learning theory; and a multivariate perspective that stresses the importance of collecting multimodal and multimethod assessment data as the basis of a case formulation.

The functional analysis occupies a central role in behavioral construct systems and in behavior therapy. However, examination of the literature suggests that it is a conceptually amorphous term with multiple definitions. Such imprecision has resulted in inconsistency and restricted applications in clinical case conceptualizations and clinical decision-making. In order to clarify the nature of the functional analysis, this paper examines its epistemological bases and important dimensions of functional relationships. A definition of functional analysis is proposed that integrates the important characteristics of functional relationships with the tenets of behavioral construct systems. This definition can accommodate complex causal models which more accurately depict the behavioral interrelationships presented by most clients. Methods for deriving the functional analysis are then examined. A review of the literature suggests that pretreatment functional analyses are infrequently conducted. The construction of functional analytic causal models is proposed as a method of systematizing and organizing the functional analysis and facilitating its clinical impact.