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191.
Low family socioeconomic status (SES) is a robust risk factor for adverse child outcomes, yet the specific processes that account for this risk are not fully understood. This study examines whether and how variation in two adverse factors, stressful life events and harsh parental discipline, affect children’s social competence within a high-risk environment, and whether some children are more vulnerable to these effects than others. Data were collected from 207 families of kindergarten children at risk for behavioral maladjustment. Children’s physiological regulation (respiratory sinus arrhythmia; RSA) measured during rest was examined as a moderator of risk exposure. Results indicate that both greater exposure to life stress and harsh discipline were correlated with lower social competence. Although children’s resting RSA was not a direct predictor of their social competence, it moderated the association between life stress and social competence. Greater exposure to life stress was more strongly associated with lower social competence among children with lower resting RSA. Higher RSA may help to buffer the effects of stress and facilitate appropriate social development. RSA did not moderate the effects of harsh discipline. This differential pattern of findings suggests that children’s physiological regulation can facilitate an effective response to situational stressors, but may be less efficacious in buffering against stress in the context of the parent-child relationship.  相似文献   
192.
The objective of this study was to assess the genetics knowledge of patients with Parkinson’s disease (PD), and to explore their attitudes on genetic testing and interest in genetic counseling. We surveyed 158 patients from the University of Maryland Parkinson’s Disease and Movement Disorders Center. Patients averaged a score of 63% on general genetics knowledge and 73% on PD genetics knowledge. Participants had an overall positive attitude toward genetic testing: 80% believed that the use of genetic tests among people should be promoted, and 83% would undertake genetic test for PD if it was available. Patients reported a high interest to discuss the benefits, risks, and impacts of genetic testing for PD (mean sum score?=?26, range?=?9–35), and 43% patients expressed interest in meeting with a genetic counselor. Multivariate regression analysis showed that patients who had more positive attitudes toward genetic testing for PD were more interested in meeting with a genetic counselor (β?=?0.6, p?<?0.001). This study is the first to demonstrate an interest in genetic counseling among patients with PD. Our findings demonstrate a new niche for genetic counselors to support patients in clarifying gaps or misconceptions in knowledge about PD genetics as well as the possible risks, benefits, and limitations of genetic testing.  相似文献   
193.
Cognitive-behavioral therapy (CBT), consisting of exposure and response prevention (EX/RP), is both efficacious and preferred by patients with obsessive–compulsive disorder (OCD), yet few receive this treatment in practice. This study describes the implementation of an Internet-based CBT program (ICBT) developed in Sweden in individuals seeking OCD treatment in New York. After translating and adapting the Swedish ICBT for OCD, we conducted an open trial with 40 adults with OCD. Using the RE-AIM implementation science framework, we assessed the acceptability, feasibility, and effectiveness of ICBT. The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure. Of 40 enrolled, 28 participants completed the 10-week ICBT. In the intent-to-treat sample (N = 40), Y-BOCS scores decreased significantly over time (F = 28.12, df = 2, 49, p < . 001). Depressive severity (F = 5.87, df = 2, 48, p < . 001), and quality of life (F = 12.34, df = 2, 48, p < . 001) also improved. Sensitivity analyses among treatment completers (N = 28) confirmed the intent-to-treat results, with a large effect size for Y-BOCS change (Cohen’s d = 1.38). ICBT took less time to implement than face-to face EX/RP and participants were very to mostly satisfied with ICBT. On a par with results in Sweden, the adapted ICBT program reduced OCD and depressive symptoms and improved quality of life among individuals with moderate to severe OCD. Given its acceptability and feasibility, ICBT deserves further study as a way to increase access to CBT for OCD in the United States.  相似文献   
194.
Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortunately, little is known about the beliefs parents hold regarding accommodation, as there exists no validated measure of this construct. First, the psychometric properties were examined for the Parental Accommodation Scale (PAS), a novel measure of parental accommodating behavior frequency (PAS-Behavior scale) and parental beliefs about accommodation (PAS-Belief scale). Second, the relationship between parental beliefs about accommodation and accommodation frequency was examined. Results provide preliminary evidence of the internal consistency and convergent validity of the PAS. Stronger positive beliefs about accommodation significantly predicted accommodation frequency, even after controlling for youth anxiety severity. Specifically, beliefs that accommodation prevents youth from losing behavioral and emotional control significantly predicted accommodation frequency. Therefore, efforts to decrease accommodation in clinical settings should involve correcting maladaptive parental beliefs about accommodation, with a particular emphasis on beliefs regarding the necessity of accommodation in preventing a youth from losing behavioral and emotional control.  相似文献   
195.
This modified Delphi study aimed to develop educational guidelines for integrating spirituality and spiritual care into occupational therapy education. The first round comprised a self-administered questionnaire, the second round used a face-to-face workshop, and last round reviewed the developed educational guidelines, which reached the highest agreement and median values greater than 3.25. A panel of 18 comprised occupational therapy educators, clinicians, and nursing experts were recruited. A total of 126 out of 142 items reached the highest agreements from the panel participants, categorized based on the content knowledge-based, importance, skills, ethics, pedagogical approaches, teaching and learning strategies, and assessment of student learning.  相似文献   
196.
Previous studies suggest that ancient (i.e. evolutionary-based) threats capture attention because human beings possess an inborn module shaped by evolution and dedicated to their detection. An alternative account proposes that a key feature predicting whether a stimulus will capture attention is its relevance rather than its ontology (i.e. phylogenetic or ontogenetic threat). Within this framework, the present research deals with the attentional capture by threats commonly encountered in our urban environment. In two experiments, we investigate the attentional capture by modern threats (i.e. weapons). In Experiment 1, participants responded to a target preceded by a cue, which was a weapon or a non-threatening stimulus. We found a larger cuing effect (faster reaction times to valid vs. invalid trials) with weapons as compared with non-threatening cues. In Experiment 2, modern (e.g. weapons) and ancient threats (e.g. snakes) were pitted against one another as cues to determine which ones preferentially capture attention. Crucially, participants were faster to detect a target preceded by a modern as opposed to an ancient threat, providing initial evidence for a superiority of modern threat. Overall, the present findings appear more consistent with a relevance-based explanation rather than an evolutionary-based explanation of threat detection.  相似文献   
197.
Many behavioral paradigms used to study individuals' decision‐making tendencies do not capture the decision components that contribute to behavioral outcomes, such as differentiating decisions driven toward a reward from decisions driven away from a cost. This study tested a novel decision‐making task in a sample of 403 children (age 9 years) enrolled in an ongoing longitudinal study. The task consisted of three blocks representing distinct cost domains (delay, probability, and effort), wherein children were presented with a deck of cards, each of which consisted of a reward and a cost. Children elected whether to accept or skip the card at each trial. Reward–cost pairs were selected by using an adaptive algorithm to strategically sample the decision space in the fewest number of trials. Using person‐specific regression models, decision preferences were quantified for each cost domain with respect to general tolerance (intercept), as well as parameters estimating the effect of incremental increases in reward or cost on the probability of accepting a card. Results support the relative independence of decision‐making tendencies across cost domains, with moderate correlations observed between tolerance for delay and effort. Specific decision parameters showed unique associations with cognitive and behavioral measures including executive function, academic motivation, anxiety, and hyperactivity. Evidence indicates that sensitivity to reward is an important factor in incentivizing decisions to work harder or wait longer. Dissociating the relative contributions of reward and cost sensitivity in multiple domains may facilitate the identification of heterogeneity in suboptimal decision making. Copyright © 2017 John Wiley & Sons, Ltd.  相似文献   
198.
Objective: An online intervention to improve fruit and vegetable (FV) intake examines the role of planning, outcome expectancies, self-efficacy and gender. Women are not only expected to eat more FV than men, but they are also expected to be more responsive to nutritional advice and benefit more from treatment.

Method: A two-arm digital intervention with 269 men and 395 women (Mage = 41.2, SDage = 11.45; range: 19–66 years) was conducted in Italy, Spain and Greece, followed up at three and six months, comparing a static with a dynamic, feedback-intensive platform.

Results: Linear mixed models yielded an increase in FV consumption in both the dynamic and the static intervention arms. In men, outcome expectancies were positively related to follow-up FV intake. Dietary planning interacted with self-efficacy on behavioural outcomes.

Conclusion: FV intake increased overall, and being a woman and involvement in planning facilitated behaviour change. Women seemed to be more engaged in the dynamic platform resulting in a higher amount of planning. Initial motivation, as indicated by outcome expectancies, seemed to be beneficial for men. Self-efficacious individuals benefitted from their engagement in planning, but self-efficacy did not compensate for failing to plan.  相似文献   

199.
Objectives: The primary aim of this research is to understand how mindsets about weight controllability in the United States relate to population health. We examined the distribution of people’s implicit theories of weight, from an incremental (controllable) to an entity (not controllable) mindset, in a nationally representative sample, as well as their relation to: sociodemographic factors, beliefs about behaviour and genetics as causes of obesity and engagement in weight management-relevant behaviours.

Methods: We report data from the National Cancer Institute’s Health Information National Trends Survey 4.

Results: A majority of respondents endorsed an incremental mindset of body weight, but endorsement of this mindset was stronger among younger, white respondents, and those with a higher income and more educational attainment. A stronger incremental mindset was related to stronger behaviour and weaker genetic causal beliefs about obesity, as well as a tendency to report increased engagement in weight management-relevant behaviours.

Conclusions: Our research provides evidence that although incremental mindsets are more common overall and associated with engagement in health behaviours that can contribute to or detract from population health, incremental mindsets are less common among individuals from more marginalised groups.  相似文献   

200.
This paper investigates the association of diversity practices with an important aspect of workplace well‐being, engagement. It was hypothesized that this association would be mediated by trust climate, and that this mediation relationship would be stronger when employees experienced feelings of inclusion in the workplace. Using a sample of 4,597 health sector employees, results indicated that diversity practices are associated with a trusting climate that, in turn, is positively related to employee engagement. Furthermore, the relationship between diversity practices and trust climate was moderated by inclusion. Theoretical and practical implications of the study are discussed along with recommendations for future research.  相似文献   
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