Predictors of COVID-19 precautionary behaviors to protect people with disabilities

Disability is conceptualized using one of two major frameworks: the medical and the social model of disability. The medical model of disability describes disability as an individual issue in which the appropriate intervention is to remove the disability. The social model of disability describes disability as a social construction in which the appropriate intervention is societal change to increase accessibility. This study drew on models of disability to understand predictors of engagement in COVID-precautionary behavior prior to the vaccine to protect people with disabilities (PWD) from contracting COVID-19. Participants (n = 720) with and without disabilities (n = 77 and n = 633, respectively) completed an online questionnaire measuring disability beliefs, attitudes toward PWD, concerns about PWD contracting COVID-19, and engagement in behavior protecting PWD from contracting COVID-19. Medical model beliefs were negatively associated with behavior. In addition, negative attitudes toward PWD and low concern about PWD contracting COVID-19 fully accounted for the relationship. Social model beliefs were positively associated with behavior. In addition, positive attitudes toward PWD and greater concern about PWD contracting COVID-19 partially explained the relationship. These findings suggest that framing disability as a social construction rather than a medical issue could promote greater public health behavior to protect PWD from contracting COVID.     

Implicit and explicit COVID-19-vaccine harmfulness/helpfulness associations predict vaccine beliefs,intentions, and behaviors

We investigated the role of implicit and explicit associations between harm and COVID-19 vaccines using a large sample (N = 4668) of online volunteers. The participants completed a brief implicit association test and explicit measures to evaluate the extent to which they associated COVID-19 vaccines with concepts of harmfulness or helpfulness. We examined the relationship between these harmfulness/helpfulness COVID-19 vaccine associations and vaccination status, intentions, beliefs, and behavior. We found that stronger implicit and explicit associations that COVID-19 vaccines are helpful relate to vaccination status and beliefs about the COVID-19 vaccine. That is, stronger pro-helpful COVID-19 vaccine associations, both implicitly and explicitly, related to greater intentions to be vaccinated, more positive beliefs about the vaccine, and greater vaccine uptake.     

Behavioral extremity moderates the association between certainty in attitudes about COVID and willingness to engage in mitigation-related behaviors

People generally intend to act more on beliefs and attitudes about which they have greater certainty. However, we introduce a boundary condition to the positive association between certainty and behavioral intentions—behavioral extremity. Uncertainty about a threatening issue like COVID-19 can be disconcerting, and we propose that uncertain people cope in part through increased openness to extreme actions like accepting risky medical treatments and aggression toward those defying mitigation policies. Testing this, we compiled and analyzed all the data on certainty about COVID-19 mitigation policies and willingness to engage in mitigation-related behaviors that our lab collected during the pandemic (6 samples, 20 behaviors, Ns up to 1496). External ratings of the behaviors' extremity moderated certainty-willingness associations: whereas greater certainty was associated with increased willingness to engage in moderate behaviors (the typical result), lower certainty was associated with increased willingness to engage in extreme behaviors, especially among those worried about becoming ill.     

Coping with COVID: Use,factor structure,and health behavior implications of specific emotion regulation strategies during the coronavirus pandemic

This series of studies examined U.S. individuals' use of specific emotion regulation/coping strategies during the early months of the COVID-19 pandemic, investigated the factor structure among strategies during this universally experienced stressor, and the extent to which these factors predicted engagement in COVID-related health-promoting behaviors. In Study 1, participants (N = 520) rated their use of 17 strategies for coping with pandemic-related stress during the past 24 h. Differences emerged in strategy use across demographic groups (age, race, income). Results of exploratory factor analysis suggest a factor structure grouping strategies in terms of goals beyond emotion regulation per se, rather than phases of the emotion process or a binary adaptive versus maladaptive distinction. In Study 2 (N = 264), participants reported daily on their coping strategy use and weekly on their engagement in COVID-specific health behaviors for 22 days. Results of confirmatory factor analysis replicate the factor structure found in Study 1. Some significant associations of coping strategy use with health-promoting behaviors were observed, but these were sporadic and largely involved baseline measures rather than predicting change over time. Theoretical and practical implications are discussed.     

Loneliness and the sexual behavior of sexual minority men in the context of the COVID-19 pandemic

In March 2020, in response to the COVID-19 pandemic, Canadian provincial governments instituted a variety of public health measures that included social distancing and isolation, which may have had unintended consequeses. According to the Loneliness and Sexual Risk Model, gay, bisexual, and other men who have sex with men (GBM) often cope with loneliness through risky sexual behaviors. Previous studies have demonstrated that COVID-19 measures such as social distancing and isolation led to increases in loneliness; thus, these measures may also have led to elevated sexual risk-taking among some GBM. Participants were recruited from an ongoing cohort study on GBM health and well-being, and were included in the current analysis if they had completed relevant study questions (n = 1134). GBM who reported lower levels of social support pre-COVID-19, were younger, and lived alone each reported greater loneliness during the first year of COVID-19. Although feelings of loneliness did not predict sexual risk-taking within the first year of COVID-19, loneliness did predict greater sexual risk-taking 6 months later. Additionally, younger GBM and those living alone were more likely to engage in sexual risk-taking at both COVID-19 data collection points. These findings offer some support of the Loneliness and Sexual Risk Model; however, it is possible that the unique circumstances of the COVID-19 pandemic resulted in a temporary suspension of this association, as many GBM took steps to protect themselves and partners in the context of COVID-19.     

Neuropsychiatric and experiential correlates of violent juvenile delinquency

This article reviews evidence regarding contributions of neuropsychiatric and psychological vulnerabilities to violent delinquency, and the interaction between intrinsic vulnerabilities and experiential factors in the genesis of antisocial juvenile behavior. Consideration is given to biochemical and physiological factors, genetics, medical status, and neurological, psychiatric, and neuropsychological factors. Implications for treatment are discussed.     

Behavioral case formulation: An experimental assessment study of transient tic disorder

A nine-year-old male, who met DSM III-R criteria for transient tic disorder, participated in an experimental assessment strategy to generate support for a case formulation. In addition to presenting motor disturbance, assessment procedures revealed six problem areas. All problems were formulated as manifestations of a hypersensitivity to evaluation, etiologically related to the boy's relationship with an insecure and critical father. It was hypothesized that the patient's tic disorder was a consequence of his hypersensitivity to father's excessive criticism, which then generalized to other evaluative situations. Using a controlled single-subject design, predictions derived from the formulation were tested by exposing the child to a planned combination of evaluative observers (e.g., father, mother, therapist, etc.) who watched him as he worked on a series of puzzles. The dependent measures included (1) behavioral recordings of tic frequency and (2) frontalis EMG responses. The results indicated significant differences in tic rate and EMG as a function of the type of observer. Consistent with the formulation, the patient displayed the highest levels of tic behavior and EMG response when his father was the observer and lowest in the presence of the mother. Predictions regarding other stimulus conditions were also confirmed. These results provided support for the case formulation that was used to design an effective treatment intervention. Findings suggest that the case formulation model offers a method whereby novel case hypotheses can be generated for poorly understood psychopathology and tested later in the experimental situation.     

Utility maximization and melioration: Internalities in individual choice

How do people go about choosing between alternatives in relatively simple settings? This study explores some of the variables that past work suggests may be relevant. Volunteer subjects worked for money in six procedures in which the probability of a payment from either of two alternatives was 1.0, but the rate of pay (i.e. the speed with which a payment was delivered or the size of the payment) interacted with the subjects recent allocation of choices, which we define as the ‘internalities’. Because of the internalities, choosing the currently more profitable alternative did not maximize total earnings. Subjects were more likely to fail to maximize when the interaction between present pay and past choices was spread over longer sequences of choices, or when the reward variable was the speed, rather than the value, of each payment. Subjects often disregarded the internalities and were instead guided by the current yields of the two alternatives, which is a frequently observed tendency, called ‘melioration’, in experiments on choices by animals. The tendency toward melioration was only partially counteracted by explicit instructions on how to maximize earnings. We discuss a theoretical framework for melioration that postulates both motivational and cognitive sources.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

EXPERIMENTAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED SELF-INJURY

A functional analysis of the self-injurious behavior (SIB) of 3 adults with profound developmental disabilities showed that each engaged in SIB in more than one assessment condition. Such outcomes may result from a failure to isolate the variable maintaining SIB, or they may reflect multiple sources of control over SIB. In order to identify more clearly the determinants of SIB, each subject was exposed to a series of treatments appropriate to one or both of the apparent functions of SIB. These treatments, applied sequentially on baselines appropriate to each behavioral function, identified the maintaining variables for SIB through differential outcomes across baselines. Results indicated that the SIB of 2 subjects was multiply controlled, confirming the outcomes of the functional analysis. However, the SIB of the 3rd subject was eliminated using a treatment designed for a single function, suggesting spurious results of the original assessment. Alternative interpretations of undifferentiated assessment data are discussed, as are analysis and treatment issues related to multiply determined behavior disorders.