Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self-management for African Americans with hypertension

African Americans are at significantly greater risk of hypertension and worse cardiovascular outcomes than other racialized groups, yet hypertension intervention effects remain limited. Thus, it is necessary to understand the potential mechanisms whereby interventions may be more effectively targeted to improve health. Supported by prior research evidence and guided by the Biobehavioral Family Model, this study examined associations between family relationship quality, psychological wellbeing, and self-management behaviors for African Americans with hypertension. Data were pooled from three Midlife Development in the U.S. projects, resulting in a sample of 317 African Americans (63.4% female, M_age = 53.32) with self-reported high blood pressure in the past 12 months. We tested four cross-sectional multiple mediator models, with depressed mood and environmental mastery mediating associations between family strain and exercise, smoking, problematic alcohol use, and stress-eating. Environmental mastery mediated the association between greater family strain and decreased odds of achieving recommended exercise levels; greater odds of reporting problematic alcohol use; and greater stress-eating. Though family strain was associated with depressed mood in each model, this variable did not serve as an indirect pathway to self-management behaviors. Family strain, and the potential pathway identified via environmental mastery, may be a meaningful predictor of disease self-management for African Americans with hypertension. Longitudinal studies are needed to examine directionality and to support intervention trials for improving self-management and hypertension outcomes.     

Effects of inferiority and superiority in groups on recognition memory and confidence

Summary Three dependent variables were derived from an extended Signal-Detection paradigm: memory performance, confidence level, and response-bias. In the assessment of memory items, S and 2 confederates were exposed periodically to fictitious results which implied inferiority or superiority of S. Memory performance was generally better in group situations than when the subject was alone. Within groups, inferiority motivated S to improve. Significant confidence differences between correct and false judgments and, if S judged falsely, a high susceptibility to cognitions about S's relative performance, led theoretically to a distinction between internal and external cues and to the assumption that S wished to avoid uncertainty. Response-bias was found to be independent of motivation and very close to expected stimulus occurrence. The reward/cost theory of Thibaut and Kelley accounts for the motivation engendered and is linked to some theoretical considerations about processing objectively classifiable stimuli in social context.

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Zusammenfassung Aus einem erweiterten Signal-Detection-Paradigma wurden 3 abhängige Variablen abgeleitet: Gedächtnisleistung, Sicherheitsniveau und Response-bias. Bei der Beurteilung von Gedächtnisaufgaben wurden einer Vp und 2 Mitwissern des Vl von Zeit zu Zeit fiktive Ergebnisse gezeigt, die entweder Unterlegenheit oder Überlegenheit der Vp induzierten. Verglichen mit einer Alleinsituation stieg die Gedächtnisleistung allgemein in Gruppensituationen. Innerhalb von Gruppensituationen wurde die Vp durch Unterlegenheit motiviert, sich zu verbessern. Signifikante Unterschiede in der Sicherheit zwischen richtigen und falschen Urteilen und hohe Beeinflußbarkeit durch Kognitionen über den relativen Leistungsstand der Vp bei Fehlerurteilen führte theoretisch zu einer Unterscheidung zwischen innerem und äußerem Aufschluß und zu der Annahme, daß die Vp Unsicherheit vermeiden will. Der gefundene Response-bias war unabhängig von Motivation und sehr nahe bei der Wahrscheinlichkeit des Auftretens der Reize. Die reward/cost Theorie von Thibaut und Kelley kann die erzeugte Motivation erklären und wird mit einigen theoretischen Überlegungen über die Verarbeitung objektiv definierbarer Reize im sozialen Kontext verknüpft.

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This research was supported by research grants from the Deutsche Forschungsgemeinschaft allotted to the Sonderforschungsbereich 24 at the University of Mannheim, West Germany. We are grateful to Mary Madden, Pauline Sadler, and Jennifer S. Sentance for their cooperation on the English translation.

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This article is partly based on a Diplom-thesis by the second author entitled Effekte von Überlegenheit und Unterlegenheit in Gruppen auf Gedächtnisleistung und Skalengebrauch.     

Effects of agreement and disagreement in groups on recognition memory performance and confidence

Three dependent variables, derived from an extended Signal-Detection paradigma, were used in each of 3 experiments: memory performance, confidence-level, and response-bias. Each memory item was first judged by S and then fictitiously by 2 confederates providing different degrees of agreement and disagreement. As compared to agreement moderate disagreement yielded both better recognition performance and, if S's judgements were false, less confidence. Strong disagreement failed to repeat these findings. Balanced agreement/disagreement raised the level of both performance and confidence relative to a situation without information from the group. In all the experiments correct decisions yielded higher confidence than errors. Festinger's theory of social comparison processes accounts for all results in performance, but for explaining the confidence shifts assumptions on ‘internal cues’ should also be incorporated. The response-bias was not affected by social treatment differences, thus supporting the view of some Signal-Detection theorists. Proposals towards a general theory of stimulus processing in social context are outlined and some of its consequences are discussed by taking as examples some conformity experiments.     

The semiautomatic Wisconsin general test apparatus

A semiautomatic version of the Wisconsin General Test Apparatus is described along with circuitry. Comparison data are provided for the semiautomatic and manual WGTA obtained under comparable procedures and conditions. Response latencies are given for go/no-go object discrimination problems and subsequent retention tests.     

An inexpensive electro-fistular swivel for negative feedback control of self-stimulation

A swivel was developed for concurrent intraorganismic fluid injection and intracranial electrical stimulation of the unrestrained rat. Effects of various intragastric injections on bar-pressing maintained by electrical stimulation of the hypothalamus were studied. In some subjects, intragastric injections of either water or milk decreased the rate of responding. This decrease resulted from pauses in responding rather than from decreases in the local rates of responding. The decrement in responding occurred at a lower gastric volume during milk injection than during water injection. In other subjects, however, neither water, milk, nor 32% sucrose injections affected the rate of self-stimulation.     

Carbon dioxide as a reinforcer in escape conditioning

The effects of varying CO₂ concentration, and intervals between CO₂ presentations, were determined from the performance by five pigeons of a learned motor act which eliminates CO₂ from the inspired air. The length of time from the onset of an externally-produced increase in inspired CO₂ to the performance of the learned motor response terminating the CO₂ presentation was inversely related to the CO₂ concentration presented (3 per cent and 5 per cent) and directly related to the inter-trial interval (3 minutes and 1.5 minutes). Chemoreceptors on the ventrolateral surfaces of the medulla are postulated to be the initial site of stimulation in the chain of events leading to the behavioral bioregulation of inspired CO₂ concentration.     

The dead donor rule: should we stretch it, bend it, or abandon it?

The dead donor rule--that persons must be dead before their organs are taken--is a central part of the moral framework underlying organ procurement. Efforts to increase the pool of transplantable organs have been forced either to redefine death (e.g., anencephaly) or take advantage of ambiguities in the current definition of death (e.g., the Pittsburgh protocol). Society's growing acceptance of circumstances in which health care professionals can hasten a patient's death also may weaken the symbolic importance of the dead donor rule. We consider the implications of these efforts to continually revise the line between life and death and ask whether it would be preferable to abandon the dead donor rule and rely entirely on informed consent as a safeguard against abuse.