INCREASING APPOINTMENT KEEPING BY REDUCING THE CALL-APPOINTMENT INTERVAL

We examined the effect of reducing the interval between a patient's call for an appointment and the appointment itself. In Experiment 1, patients calling a family planning unit of a public health department were assigned appointments within either 1 or 3 weeks of their call. Data on patient “shows” and “no-shows” were recorded weekly for 6 weeks. Show rates for those in the 1-week appointment group were significantly higher than those in the 3-week group. In Experiment 2, patients were assigned to appointment dates either the next operating clinic day (next-day group) or 2 weeks from the call date (2-week group). Show rates for those in the next-day group were significantly better than show rates for patients in the 2-week group. Clinic productivity, time spent with patients, and consumer satisfaction were also assessed. Implications for appointment scheduling are discussed.     

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.     

Diverse middle school students’ future career autobiographies and socioeconomic status factors: A content analysis

The future career autobiography (FCA) is a narrative, discovery-based career intervention designed to assess individuals’ career hopes and dreams. In total, 134 low-income, ethnically and racially diverse middle school students participated in an FCA intervention through a yearlong grant-funded career development initiative. Using content analysis, we analyzed participants’ FCAs for socioeconomic status factors and lifestyle indicators. We found that participants articulated occupational and lifestyle factors more than education and income, and that there were differences based on biological sex, race, and ethnicity. We present pertinent results and discuss implications for counseling practice and future research.     

Resource scarcity aggravates ingroup bias: Neural mechanisms and cross-scenario validation

Previous studies examining the relationship between ingroup bias and resource scarcity have produced heterogeneous findings, possibly due to their focus on the allocation of positive resources (e.g. money). This study aims to investigate whether ingroup bias would be amplified or eliminated when perceived survival resources for counteracting negative stimuli are scarce. For this purpose, we exposed the participants and another confederate of the experimenters (ingroup/outgroup member) to a potential threat of unpleasant noise. Participants received some ‘relieving resources’ to counteract noise administration, the amount of which may or may not be enough for them and the confederate in different conditions (i.e. abundance vs. scarcity). First, a behavioural experiment demonstrated that intergroup discrimination manifested only in the scarcity condition; in contrast, the participants allocated similar amounts of resource to ingroup and outgroup members in the abundance condition, indicating a context-dependent allocation strategy. This behavioural pattern was replicated in a follow-up neuroimaging experiment, which further revealed that when contrasting scarcity with abundance, there was higher activation in the anterior cingulate cortex (ACC) as well as stronger functional connectivity of the ACC with the empathy network (including the temporoparietal junction and medial prefrontal cortex) for ingroup compared to outgroup members. We suggest that ACC activation reflects the mentalizing process toward ingroup over outgroup members in the scarcity condition. Finally, the ACC activation level significantly predicted the influence of resource scarcity on ingroup bias in hypothetical real-life situations according to a follow-up examination.     

Further evaluation of prompt density,rate of reinforcement,and the persistence of manding

Previous research has evaluated the effects of prompt rates on the rate of communicative behavior. More recent research has suggested that dense prompting can result in communicative behavior that is more resistant to change. However, existing research has not considered the impact that higher response rates had on reinforcement rate, a variable known to impact response persistence. The current study systematically replicated previous research by evaluating communicative responding in contexts associated with dense- and lean-prompt schedules and extended existing research by (a) holding reinforcement rates similar across the two prompting schedules (lean and dense), and (b) evaluating the persistence of communicative responding in the contexts associated with each prompting schedule. The results for Experiment 1 clearly replicated and extended previous research. The results for Experiment 2 were equivocal and suggested that previous reinforcement history and response class size impacted outcomes.     

A Model for Adapting Evidence-Based Interventions to Be LGBQ-Affirmative: Putting Minority Stress Principles and Case Conceptualization Into Clinical Research and Practice

The mental health field now possesses clinical trials attesting to the efficacy of affirmative practice with sexual minority individuals. With the goal of efficiently moving the results of these clinical trials into real-world clinical practice, this paper offers a model for adapting existing evidence-based practices originally developed for the general population to be lesbian, gay, bisexual, and queer (LGBQ)-affirmative. The adaptation model presented here guides clinicians to incorporate six LGBQ-affirmative transtheoretical principles of change into practice. These principles facilitate raising awareness of the impact of minority stress on sexual minority clients’ mental health and on client self-evaluation while drawing upon sexual minority resilience and intersectional experiences to build empowering coping skills and validating relationships. The adaptation model also provides a transtheoretical approach to case conceptualization that directs clinicians to consider the role of early and ongoing minority stress on sexual minority clients’ cognitive, affective, motivational, behavioral, and self-evaluative experiences that maintain current distress. This case conceptualization approach highlights common associations among these experiences, suggesting clear routes of interventions for many sexual minority client presentations. Case examples from recent clinical trials of LGBQ-affirmative cognitive-behavioral therapy illustrate how these principles and this case conceptualization can be effectively utilized in practice. While the principles and case conceptualization are meant to be transtheoretical and therefore applicable across therapeutic techniques, to date they have been tested only in clinical trials for cognitive-behavioral treatments. Therefore, this paper concludes with a call for future research to determine the effectiveness of implementing this adaptation model across diverse therapeutic modalities and client presentations.     

Correspondence between resident- and staff-report on the QABF: Do justice-involved youth agree with residential staff?

Residents in juvenile residential treatment facilities (JRTFs) often display various emotional, behavioral, and educational needs. Researchers have recently developed behavioral interventions to increase residents' appropriate behavior such as cooperation with facility staff instructions, accepting feedback from facility staff, and tolerating unpleasant events. However, there is not a generally accepted tool for assessing the operant function of residents' problem behavior in JRTFs. For various logistical reasons, indirect functional assessments may be more appropriate in a JRTF than manipulating either antecedent or consequent events. This study obtained scores on the Questions About Behavior Function (QABF) assessment for 17 residents from two dormitory staff members for each resident. To increase the number of respondents, each resident completed a QABF for their own behavior. Results revealed moderate to high correspondence (i.e., agreement) for highest and lowest potential operant function of problem behavior between combinations of JRTF staff and residents. These preliminary findings suggest additional research with the QABF in JRTFs is warranted.     

Affection deprivation is more aversive than excessive affection: A test of affection exchange theory

Affection exchange theory predicts that both excessive affection and affection deprivation are associated with poorer health, compared with receiving the level of affectionate communication that one desires. A similar yet-untested prediction is that affection deprivation is more aversive than excessive affection. This preregistered study tested both hypotheses on a battery of mental and physical health outcomes, including depression, loneliness, stress, physical pain, frequency of nightmares, and sleep quality, using a Census-matched sample of U.S. American adults (N = 827). As hypothesized, receiving the right amount of affection was associated with more health-supportive scores on all outcomes than either excessive or deficient affection. Similarly, excessive affection was associated with lower depression, loneliness, stress, and pain, and higher sleep quality, than affection deprivation.     

Does authenticity always breed mental health? A cross-cultural comparison between the United States and China

Numerous studies on Western cultures have suggested a strong linkage between authenticity and mental health. However, little is known about whether such an association can be generalized to Eastern cultures. This study aimed to conduct a cross-cultural comparison on the association between three dimensions of authenticity (authentic living, self-alienation, and accepting external influence) and two factors of mental health (negative and positive) across Western and Eastern cultures. Measurement invariance tests were carried out and multigroup structural regression models developed on two college samples from the US (n = 392) and China (n = 281). Results suggested that the associations between authenticity and the negative factor of mental health were consistent across cultures, where both self-alienation and accepting external influence were positively associated with anxiety. However, the associations between authenticity and the positive factor of mental health were different in the US and Chinese samples. Specifically, both authentic living and accepting external influence were significantly associated with life satisfaction in the US sample but not in the Chinese sample. Findings stress that having a nondistorted perception of the true self is critically related to lower levels of anxiety across cultures and highlighted the need to identify culture-specific promotive factors for life satisfaction.