Emotional responses to behavioral economic incentives for health behavior change

Many people aim to change their lifestyle, but have trouble acting on their intentions. Behavioral economic incentives and related emotions can support commitment to personal health goals, but the related emotions remain unexplored. In a regret lottery, winners who do not attain their health goals do not get their prize but receive feedback on what their forgone earnings would have been. This counterfactual feedback should provoke anticipated regret and increase commitment to health goals. We explored which emotions were actually expected upon missing out on a prize due to unsuccessful weight loss and which incentive-characteristics influence their likelihood and intensity. Participants reported their expected emotional response after missing out on a prize in one of 12 randomly presented incentive-scenarios, which varied in incentive type, incentive size and deadline distance. Participants primarily reported feeling disappointment, followed by regret. Regret was expected most when losing a lottery prize (vs. a fixed incentive) and intensified with prize size. Multiple features of the participant and the lottery incentive increase the occurrence and intensity of regret. As such, our findings can be helpful in designing behavioral economic incentives that leverage emotions to support health behavior change.     

Moral injury and the ethics of teaching tainted legacies

Cases like that of John Howard Yoder – a pacifist theorist who perpetrated sexual violence – raise difficult questions about teaching material implicated in traumatic pasts. This paper argues that “moral injury” provides a useful framework for understanding the dynamics of teaching prominent cases of tainted legacies like Yoder's and for developing best pedagogical practices across the field of religious ethics. The moral injury framework empowers students to think critically and self‐reflectively about authority, conceptions of the good, the various stakes for different persons and communities in social issues, and the need for moral repair. It establishes the importance of professor and student preparation; propels students into the moral questioning and analysis that constitutes “ethics”; draws attention to the connections between and intersectionality of various moral problems while also attending to important moral distinctions; and affords opportunities to study individual and institutional efforts at moral repair.     

‘Hope givers’? A scoping review of new media and mental health in 27 Australian Christian organisations

This article explains a range of conceptual and methodological innovations in the use of new media for the clinical practice and public communication of mental health. Building on two current contexts – the emerging research area of new media and mental health, and major reform of the mental health system in Australia – this article presents a scoping review of the online communication of Christian organisations that offer mental health care in Australia. This article compares the websites of 27 Australian Christian mental health organisations, analysing these organisations’ configurations of mainstream and religious modalities of mental health care, their discursive and visual communication strategies, as well as their use of social media platforms.     

Concurrent tobacco use and risky drinking in South Africa: Results from the South African National Health and Nutrition Examination Survey

The aim of this study was to examine socio-demographic and psychosocial correlates of concurrent tobacco use and risky drinking. We analysed data from the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) 2011–2012. The sample included 14 764 adolescents and adults aged 15 years and older. They responded to questions on tobacco and alcohol use, psychosocial, and socio-demographic indicators. Results indicate that 9.6% (16.8% among men and 3.5% among women) of South Africans were involved in concurrent tobacco use and risky drinking, 18.2% in current tobacco use only, and 20.3% in risky drinking only. In covariate adjusted analysis, being 25 to 64 years, being male, belonging to the coloured population group, residing in urban areas, having experienced three or more traumatic events, and poor self-rated health were associated with concurrent tobacco use and risky drinking. Findings suggest socio-demographic and health factors are important for public health interventions in addressing concurrent tobacco and alcohol use in South Africa.     

Madhouse and the whole thing there

This article presents an autoethnography in the form of a short story of the experiences of a mental breakdown, and subsequent involuntary detainment, alongside the experiences of conducting PhD research outside the mainstream of the discipline of psychology. In response to criticisms of narrative approaches that they are methodologically solipsistic and present a socially atomised self, this narrative combines patient medical records with narrative recollections and reflections on the research process from a contemporary perspective. In doing so, the narrative explores and interrogates themes relevant to creative practice in psychological research, including the notion of authenticity, methodological issues of researching personal experience, the problem of subjectivity and, ultimately, the nature of madness and psychological distress, including its nonlinearity and otherness.     

Staff and Administrators’ Perceptions of Music Therapy with Acute Care Mental Health Inpatients: A Qualitative Investigation

The purpose of this qualitative study is to understand staff members’ and administrators’ perceptions of group-based music therapy in an acute care mental health setting. The researcher conducted semi-structured interviews with six experienced administrators and unit staff who were familiar with music therapy. Using an inductive approach to thematic analysis, the author identified six themes: (a) music constitutes an important role in patients’ lives, (b) patient-centricity and competence of the music therapist, (c) music therapy uniquely engages the patient with music, the music therapist, and peers, (d) music therapy shifts patients’ focus from internal to external, (e) music therapy is a normalizing experience that facilitates interaction, and (f) music therapy provides optimal conditions for cognitive, affective, and behavioral change. Implications for clinical practice, suggestions for future research, and limitations of the study are provided.     

In Defense of “Denial”: Difficulty Knowing When Beliefs Are Unrealistic and Whether Unrealistic Beliefs Are Bad

Bioethicists often draw sharp distinctions between hope and states like denial, self-deception, and unrealistic optimism. But what, exactly, is the difference between hope and its more suspect cousins? One common way of drawing the distinction focuses on accuracy of belief about the desired outcome: Hope, though perhaps sometimes misplaced, does not involve inaccuracy in the way that these other states do. Because inaccurate beliefs are thought to compromise informed decision making, bioethicists have considered these states to be ones where intervention is needed either to correct the person’s mental state or to persuade the person to behave differently, or even to deny the person certain options (e.g., another round of chemotherapy). In this article, we argue that it is difficult to determine whether a patient is really in denial, self-deceived, or unrealistically optimistic. Moreover, even when we are confident that beliefs are unrealistic, they are not always as harmful as critics contend. As a result, we need to be more permissive in our approach to patients who we believe are unrealistically optimistic, in denial, or self-deceived—that is, unless patients significantly misunderstand their situation and thus make decisions that are clearly bad for them (especially in light of their own values and goals), we should not intervene by trying to change their mental states or persuade them to behave differently, or by paternalistically denying them certain options (e.g., a risky procedure).     

Association splitting of the sexual orientation-OCD-relevant semantic network

There is little research on treating symptoms of sexual orientation-obsessive-compulsive disorder (SO-OCD). Semantic networks represent a new cognitive approach for understanding cognitive mechanisms of SO-OCD. Specifically, we tested whether the self-help cognitive technique of association splitting (AS) developed from this approach would be efficacious in reducing SO-OCD symptoms and thought suppression. One hundred and twenty heterosexual undergraduates (82 females, 38 males) were randomly assigned to either the AS or waitlist control group. At baseline and four weeks later, participants completed items assessing SO-OCD symptoms, measures of sexual obsessions and thought suppression, and an association task in which they generated associations to different cue words. Generated associations were coded based on SO-OCD relevance and emotional valence. Results indicated reductions in SO-OCD-relevant associations across levels of emotional valence and SO-OCD-irrelevant negative associations, and increases in SO-OCD-irrelevant positive and neutral associations, only in the AS group. Furthermore, there were reductions in SO-OCD symptoms, sexual obsessions, and thought suppression only in the AS group. Importantly, these findings were obtained with overall large effect sizes. AS appears to be an efficacious self-help technique in reducing SO-OCD symptoms, sexual obsessions, and thought suppression. Clinical implications, limitations, and suggestions for future research are discussed.     

Intersectional experiences of discrimination in a low‐resource urban community: An exploratory latent class analysis

There have been increasing calls for the application of an intersectionality framework to understand and address discrimination and health inequities among diverse communities. Yet there have been theoretical debates regarding to whom intersectionality applies and how intersectional experiences of discrimination are associated with health outcomes. The current study aimed to contribute to these theoretical debates and inform practical applications to reduce health inequities. Data were drawn from a community health survey in New Haven, CT (N = 1,293 adults) and analysed using latent class analysis. Results yielded 4 classes. Members of the 4 classes were similar sociodemographically. Three classes of participants reported experiencing discrimination, and members of these classes had greater stress, higher rates of smoking and sleep disruption, and worse overall health than members of the class reporting no discrimination. Members of 2 classes made multiple, or intersectional, attributions for discrimination, and members of these classes reported the most frequent discrimination. Findings suggest that community members who are sociodemographically similar may have diverse discrimination experiences. Multilevel interventions that address multiple forms of discrimination (e.g., racism and sexism) may hold promise for reducing discrimination and, ultimately, health inequities within low‐resource urban community settings.