Why Doesn’t He Just Leave Me Alone? Persistent Pursuit: A Critical Review of Theories and Evidence

An integrative review of three theories that explain why some individuals engage in persistent pursuit—coercive control theory, relational goal pursuit, and attachment theory—is presented. The meta-analytic evidence pointing to persistent pursuit as a gendered behavior is reviewed, and coercive control theory is used to explain gender differences. The strong conceptual and empirical overlap between coercive control as a form of intimate partner violence and persistent pursuit is examined. It is suggested that persistent pursuit measures do not adequately assess behaviors that may be used more commonly by women, such as use of physical attractiveness or gossip to damage one’s reputation. Given the promising empirical support for the theories, longitudinal and comparative evaluations, with new methods are needed.     

Episodic repetitive thought: dimensions, correlates, and consequences

Repetitive thought (RT) - attentive, prolonged, or frequent thought about oneself and one's world - plays an important role in many models of psychological and physical ill health (e.g., rumination and worry), as well as models of recovery and well-being (e.g., processing and reminiscing). In these models, repetitive thought is typically treated as stable or trait-like. In contrast, episodic RT reflects what people have "on their minds" at a particular point in time. In four studies, young women (N=94), college students (N=166), first-year law students (N=73), and older adults (N=174) described their episodic RT, which was then rated for qualities including valence, purpose, and theme. Episodic RT valence was associated with mood and depressive symptoms both between (Studies 1-4) and within people (Studies 3-4), and it mediated the effects of dispositional coping through emotional approach (Study 1). The effect of episodic RT valence in turn was moderated by other properties of episodic RT, including purpose, "trait" valence, and theme (Studies 1-4). The study of episodic RT complements that of trait RT and allows for observations of how RT and psychological adjustment change in concert and in context, as well as examining how the RT qualities that are not reflected in trait measures affect adjustment.     

Family Physicians’ Awareness and Knowledge of the Genetic Information Non-Discrimination Act (GINA)

Historically, physicians have expressed concern about their patients’ risk of genetic discrimination, which has acted as a barrier to uptake of genetic services. The Genetic Information Nondiscrimination Act of 2008 (GINA) is intended to protect patients against employer and health insurance discrimination. Physicians’ awareness and knowledge of GINA has yet to be evaluated. In 2009, we mailed surveys to 1500 randomly selected members of the American Academy of Family Physicians. Questions measured physicians’ current knowledge of GINA and their level of concern for genetic discrimination. In total, 401 physicians completed the survey (response rate 26.9%). Approximately half (54.5%) of physicians had no awareness of GINA. Of physicians who reported basic knowledge of GINA, the majority were aware of the protections offered for group health insurance (92.7%), private health insurance (82.9%), and employment (70.7%). Fewer physicians were aware of GINA’s limitations regarding life insurance (53.7%) and long-term care insurance (58.8%). Physicians demonstrated highest levels of concern for health insurance, life insurance, and long-term care insurance discrimination, with less concern for employer and family/social discrimination. Level of concern for the risk of genetic discrimination did not correlate significantly with awareness of GINA. Approximately 17 months after GINA was signed into federal law, physicians’ knowledge remained limited regarding the existence of this legislation and relevant details. Physicians who are aware of GINA continue to have significant concerns regarding the risk of genetic discrimination. This study reveals the need to further educate physicians about the existence of GINA and the protections offered.     

The Performance of Multivariate Methods for Two-Group Comparisons with Small Samples and Incomplete Data

Abstract

In intervention studies having multiple outcomes, researchers often use a series of univariate tests (e.g., ANOVAs) to assess group mean differences. Previous research found that this approach properly controls Type I error and generally provides greater power compared to MANOVA, especially under realistic effect size and correlation combinations. However, when group differences are assessed for a specific outcome, these procedures are strictly univariate and do not consider the outcome correlations, which may be problematic with missing outcome data. Linear mixed or multivariate multilevel models (MVMMs), implemented with maximum likelihood estimation, present an alternative analysis option where outcome correlations are taken into account when specific group mean differences are estimated. In this study, we use simulation methods to compare the performance of separate independent samples t tests estimated with ordinary least squares and analogous t tests from MVMMs to assess two-group mean differences with multiple outcomes under small sample and missingness conditions. Study results indicated that a MVMM implemented with restricted maximum likelihood estimation combined with the Kenward–Roger correction had the best performance. Therefore, for intervention studies with small N and normally distributed multivariate outcomes, the Kenward–Roger procedure is recommended over traditional methods and conventional MVMM analyses, particularly with incomplete data.     

From self-reliers to expert-dependents: identifying classes based on health-related need for autonomy and need for external control among mobile users

ABSTRACT

Mobile health apps are seen as promising tools to support autonomous consumers in their quest for better health. However, individual differences in the need for autonomy and need for external control may impact the degree to which individuals perceive mobile health apps to be useful in their daily life. Using data from a representative sample of the Dutch population (N = 1,027), we applied latent class analysis to identify subtypes among mobile users based on their need for autonomy and need for external control, and to examine differences among these subtypes. We identified four subgroups: the self-reliers, confirmation-seekers, expert-dependents, and indifferents. Next to demographic differences, self-reliers and confirmation-seekers were generally more e-health literate and expressed more privacy concerns than the expert-dependents and indifferents. Our findings demonstrate that subgroups of people express different degrees of health-related need for autonomy and need for external control, which should be taken into account in online and mobile health communication efforts.