Understanding pregnant women's decision making concerning prenatal screening

OBJECTIVE: This study is aimed at enhancing understanding prenatal screening decision making through testing a hypothesized decision model based on decision theory and health behavior theory. DESIGN: We obtained questionnaires from 1,666 pregnant women who were offered prenatal screening for Down's syndrome. Path analysis (using LISREL) resulted in a final model with reasonable model fit, which was verified by split-sample cross-validation. MAIN OUTCOME MEASURES: These included perceived probability, perceived severity, attitude toward termination, response efficacy, attitude toward prenatal screening, subjective norm, child-related anxiety, and intention to undergo prenatal screening. RESULTS: Attitude toward termination of pregnancy, perceived test efficacy, and subjective norm regarding the desirability of having prenatal screening determined a woman's attitude toward having a prenatal test. Anxiety was influenced by perceived risk and perceived severity of having a child with Down's syndrome, and by subjective norm, but this appeared to be a weak predictor of intention to test. Pregnant women with a positive attitude toward prenatal screening, and who perceived a subjective norm in favor of undergoing prenatal screening, showed a greater intention to have prenatal screening done. CONCLUSION: These findings suggest that more attention should be paid toward the values and social context of pregnant women during the counseling process.     

Learning about cues that prevent an outcome: Conditioned inhibition and differential inhibition in human predictive learning

Summation tests were used to assess whether participants in a human predictive judgement task learned that some cues (foods) prevented the occurrence of the outcome (migraine). In three experiments the preventative effect of a conditioned inhibitor, I, trained in the design, P+, PI-, I-, was stronger than that of a negative control cue, N, that had been presented alone with the same frequency and simply predicted no outcome. This control cue, N, also passed the summation test when compared to a novel control cue. Experiments 2 and 3 examined whether the latter negative control effect was attributable to differential inhibition. Manipulations designed to alter context learning and the magnitude of the negative contingency did not affect the properties of the negative control cue. Thus, these experiments did not support the possibility that a cue given simple negative training acquires differential inhibition. Regardless of the mechanism underlying the negative control effect, the consistent finding that the conditioned inhibition cue, I, reduced prediction of the outcome more than did the negative control cue, N, provides evidence for true conditioned inhibition whose acquisition requires co-occurrence of the preventative cue with a positive training cue.     

Externalizing Metaphors Therapy and Innovative Moments: A Four-Session Treatment Group for Anxiety

The zeitgeist for brief services psychotherapy efficacy is well underway within the individual and family therapy treatment modalities. However, this paradigm shift, to produce clinically significant mental health outcomes in a much shorter time, has evolved to a much lesser degree within the treatment group format. Longer-term treatment group protocols typically do not match treatment-seeking behaviors with high dropout rates for clients. The current authors describe a structured, four-session treatment protocol that integrates the tenets of Externalizing Metaphors Therapy (EMT) with Innovative Moments (IMs) in addressing anxiety for children and youth. EMT is based upon the externalization of problems, transformation of metaphoric imagery, and the shifting of underlying maladaptive emotional schemas. It is suggested that treatment outcomes are enhanced through the integration of three IMs between-session exercises.     

Psychometric Properties of the Response to Anxiety Questionnaire

Recent research highlights the importance of transdiagnostic factors of psychopathology, particularly in understanding comorbidity. Repetitive negative thinking (RNT) is one such factor, which may elucidate anxiety-depression comorbidity. The Response to Anxiety Questionnaire (RAQ) aims to evaluate repetitive negative thinking (RNT) related to anxiety-depression comorbidity, specifically hopelessness and rumination about anxiety symptoms. Anxious hopelessness is negative thoughts about the future due to anxiety symptoms, and anxious rumination includes negative evaluations of the meaning of anxiety symptoms, therefore the current study assessed the RAQ in three studies. We used exploratory and confirmatory factor analysis methodologies to examine the factor structure of the RAQ. In addition, we tested indirect effects of the two factors of RAQ (Rumination and Hopelessness) between anxiety and depression, and tested measure convergent validity. Results of the current study provide additional support for the psychometric properties of the RAQ, suggesting a two factor makeup (hopelessness, rumination), as well as its use in predicting anxiety and depressive symptoms.     

A review of research on smoking among United States Veterans with posttraumatic stress disorder (2006–2016)

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders diagnosed in U.S. veterans. PTSD is associated with high smoking prevalences and difficulty quitting in the general U.S. population. The current study reviewed research on smoking and PTSD in U.S. veteran samples to summarize past research and identify areas in need of additional inquiry. MEDLINE and PsycINFO searches identified papers on smoking in samples of U.S. veterans with PTSD published from January 2006 through December 2016. Thirty-four articles met all of the inclusion criteria: (a) part of the sample consisted of U.S. veterans with PTSD or PTSD symptoms, and (b) the study examined some aspect of smoking behavior. U.S. veterans with PTSD were more likely to report smoking, heavy smoking, nicotine dependence, and late-onset smoking compared to veterans without PTSD. Smoking behaviors (e.g., current smoking, heavy smoking, smoking expectancies) differed by PTSD symptoms and by combat exposure. Smoking cessation feasibility studies examined the integration of smoking treatment into PTSD clinics and found favorable outcomes. Future research on veterans with PTSD would benefit from extending topics beyond rates of smoking to better understand the treatment needs of veterans. Research on smoking-related behaviors can help identify areas to target for interventions.     

Extreme Response Style and the Measurement of Intra-Individual Variability in Affect

Extreme response style (ERS) has the potential to bias the measurement of intra-individual variability in psychological constructs. This paper explores such bias through a multilevel extension of a latent trait model for modeling response styles applied to repeated measures rating scale data. Modeling responses to multi-item scales of positive and negative affect collected from smokers at clinic visits following a smoking cessation attempt revealed considerable ERS bias in the intra-individual sum score variances. In addition, simulation studies suggest the magnitude and direction of bias due to ERS is heavily dependent on the mean affect level, supporting a model-based approach to the study and control of ERS effects. Application of the proposed model-based adjustment is found to improve intra-individual variability as a predictor of smoking cessation.     

Navigating the Workplace: The Costs and Benefits of Shifting Identities at Work among Early Career U.S. Black Women

Although much progress has been made in race relations in the United States, discrimination still persists in the workplace. As a result, Black women, among individuals from other underrepresented groups, develop coping strategies, such as identity shifting, to diminish the negative consequences of discrimination. We used the phenomenological variant of ecological systems theory to examine shifting racial, gender, and class identities among early career (recent college graduates) U.S. Black women working in predominantly White environments. Drawing on ten semi-structured interviews with college-educated Black women, data were analyzed with an interpretative phenomenological analysis. The results revealed two major themes: (a) benefits of identity shifting and (b) the costs of identity shifting, the latter with five subthemes: (a) managing interpersonal rejection: frozen effect, (b) assimilation to the dominant culture and inauthenticity, (c) confronting and dismantling stereotypes, (d) model Black citizen, and (c) mixed feelings toward identity shifting. The findings indicate that Black women vacillate between the benefits and costs of identity shifting, altering their dialect and behavior to meet social norms. Our study’s implications suggest the necessity of a multicultural approach by employers to affirm their workers’ social identities, strengthen employee relationships, and lessen the need for shifting identities.     

Mixed Methods in Youth Purpose: An Examination of Adolescent Self-Regulation and Purpose

Utilizing a relational developmental systems approach to examining character strengths, this article examines the connection between adolescents’ intentional self-regulation (ISR) with youth sense of purpose, using data from a large-scale evaluation of a youth development program in Scotland. Data were triangulated from multiple sources, including youth surveys and interviews as well as teacher assessments. Surveys were collected from 783 S2 (approximately seventh grade) pupils; teacher survey data were collected for 732 of these pupils. Telephone interviews were conducted with a subset of 29 adolescents. The data were analyzed with an innovative mixed-methods technique that allows qualitative interview data to underscore consistencies and disconnects with quantitative findings from both teacher and adolescent surveys. Results demonstrate a strong connection between ISR and purpose and many consistencies across measures of purpose.     

Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later

Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples’ interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other’s immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally‐encoded emotional arousal (f₀) was measured during couples’ (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner’s f₀ dynamics had immediate and long‐term associations with the other partner’s satisfaction. Partners were less satisfied if the other partner (a) expressed higher f₀ overall and (b) escalated more in f₀ across the conversation. Yet, partners were more satisfied when their f₀ escalated across the conversation. Also, women specifically were more satisfied if their f₀ remained elevated longer before regulating back to their emotional baseline. Thus, higher f₀ was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner—particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner’s happiness. These findings challenge us to think of ways to address this “win–lose” scenario so that couples can balance both partners’ emotional needs and preserve relationship quality across the life span.