Intervention and mediation effects of target processes in a randomized controlled trial of Acceptance and Commitment Therapy for anxious cancer survivors in community oncology clinics.

OBJECTIVE: Acceptance and Commitment Therapy (ACT) is a promising psycho-oncological intervention, but its mechanisms in real-world settings are not fully understood. This study examined core theorized ACT and broader ACT-consistent target processes as mediators of ACT versus minimally-enhanced usual care within a randomized trial for anxious cancer survivors in a community oncology setting. METHOD: Two core theorized ACT target processes (experiential avoidance and values-aligned behavior, each measured with two instruments) and two broader ACT-consistent target processes (emotional approach coping and self-compassion) were analyzed at pre- and post-intervention as mediators of general anxiety symptoms, cancer-related trauma symptoms, and fear of cancer recurrence (N = 134). RESULTS: ACT led to greater increases on emotional approach coping (ps ≤ .001) and one measure of values-aligned behavior (ps ≤ .031), and marginal or greater improvement on self-compassion (ps ≤ .055), but not other core ACT target processes. Self-compassion and emotional approach coping mediated ACT's effects on cancer-related trauma symptoms (ps ≤ .037). Additionally, self-compassion, emotional approach coping, and values-aligned behavior marginally mediated fear of recurrence and general anxiety symptoms improvement (ps ≤ .088). CONCLUSION: ACT reduced cancer survivors' anxiety-related symptoms, and especially cancer-related trauma symptoms, most consistently by promoting self-compassion and emotional approach coping.

Randomized trial of acceptance and commitment therapy for anxious cancer survivors in community clinics: Outcomes and moderators.

OBJECTIVE: Anxiety symptoms are common among cancer survivors. This study evaluated whether an acceptance-based group intervention delivered by social workers in community oncology clinics improved anxiety and related symptoms, and healthcare use, relative to enhanced usual care (EUC). METHOD: This multi-site trial included 135 survivors of various cancers with moderate to high anxiety about cancer/survivorship, 1.5-24 months after treatment. Participants were randomized 1:1 to a 7-session acceptance and commitment therapy (ACT)-based group (Valued Living) or EUC (access to onsite supportive care plus resource list). Questionnaires were administered at baseline, 1, 2, 5, and 8 months post-randomization, diagnostic interviews at baseline, 2, and 8 months, and healthcare use tracked throughout. Outcomes included anxiety symptoms (primary), related symptoms, and healthcare use. Putative moderators included age, anxiety, and avoidance. RESULTS: In intent-to-treat comparisons to EUC, Valued Living (VL) showed a nonsignificant pattern of greater improvement on anxiety symptoms (p = .08), improved significantly more on cancer-related post-traumatic stress (p = .002), fear of recurrence (p = .003), and energy/fatigue (p = .02), and missed significantly fewer medical appointments (p < .05). Conditions improved similarly on depressive symptoms, sense of meaning, and most severe anxiety or depressive disorder. Effects were moderated: VL participants with higher baseline anxiety or avoidance (+1SD) improved more on anxiety, meaning (ps ≤ .01), and disorder severity (p = .05) than their EUC counterparts. CONCLUSIONS: An acceptance-based group intervention delivered in community oncology clinics enhanced psychological recovery and energy levels, and reduced missed medical appointments for anxious cancer survivors, with stronger effects for more distressed participants. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Validation of the Brief Perceived Ethnic Discrimination Questionnaire-Community Version in American Indians.

OBJECTIVE: The Brief Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CVB) is a widely used, multidimensional measure of exposure to ethnic/racial discrimination. The PEDQ-CVB has not been previously validated for use with American Indians, who have endured a unique history of colonization, cultural oppression, and ongoing discrimination. This study examined the measurement invariance of the PEDQ-CVB in American Indians (AIs) and 4 other groups. Additional analyses assessed the scale's convergent and discriminant validity and provided initial evidence of associations with mental and physical health in AIs. METHOD: Primary data were collected from a community sample of urban-dwelling AIs (n = 222), which included measures of ethnic/racial identity, other life stressors, and mental and physical health, along with the PEDQ-CVB. These were supplemented by secondary analysis of PEDQ-CVB data from African Americans (n = 1176), Latinos (n = 564), East Asian Americans (n = 274), and South Asian Americans (n = 242). RESULTS: The PEDQ-CVB demonstrated measurement invariance across the 5 ethnic/racial groups and convergent and discriminant validity in AIs. The PEDQ-CVB was significantly associated with depressive symptoms and physical limitations in AIs, after controlling for relevant demographics. CONCLUSION: This study provides strong evidence that the PEDQ-CVB behaves consistently for AIs and other underrepresented ethnic/racial groups. As such, the PEDQ-CVB allows for documentation of the experiences of different ethnic/racial groups and provides a means to test theoretical models of the antecedents and consequences of perceived discrimination within and across groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Avoid Cohen's 'Small', 'Medium', and 'Large' for Power Analysis.

One of the most difficult and important decisions in power analysis involves specifying an effect size. Researchers frequently employ definitions of small, medium, and large that were proposed by Jacob Cohen. These definitions are problematic for two reasons. First, they are arbitrary, based on non-scientific criteria. Second, they are inconsistent, changing dramatically and illogically as a function of the statistical test a researcher plans to use (e.g., t-test versus regression). These problems may be unknown to many researchers, but they have a huge impact on power analyses. Estimates of the required n may be inappropriately doubled or cut in half. For power analyses to have any meaning, these definitions of effect size should be avoided.

The unappreciated heterogeneity of effect sizes: Implications for power, precision, planning of research, and replication.

Repeated investigations of the same phenomenon typically yield effect sizes that vary more than one would expect from sampling error alone. Such variation is even found in exact replication studies, suggesting that it is not only because of identifiable moderators but also to subtler random variation across studies. Such heterogeneity of effect sizes is typically ignored, with unfortunate consequences. We consider its implications for power analyses, the precision of estimated effects, and the planning of original and replication research. With heterogeneity and an interest in generalizing to a population of studies, the usual power calculations and confidence intervals are likely misleading, and the preference for single definitive large-N studies is misguided. Researchers and methodologists need to recognize that effects are often heterogeneous and plan accordingly. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

New recommendations for testing indirect effects in mediational models: The need to report and test component paths.

In light of current concerns with replicability and reporting false-positive effects in psychology, we examine Type I errors and power associated with 2 distinct approaches for the assessment of mediation, namely the component approach (testing individual parameter estimates in the model) and the index approach (testing a single mediational index). We conduct simulations that examine both approaches and show that the most commonly used tests under the index approach risk inflated Type I errors compared with the joint-significance test inspired by the component approach. We argue that the tendency to report only a single mediational index is worrisome for this reason and also because it is often accompanied by a failure to critically examine the individual causal paths underlying the mediational model. We recommend testing individual components of the indirect effect to argue for the presence of an indirect effect and then using other recommended procedures to calculate the size of that effect. Beyond simple mediation, we show that our conclusions also apply in cases of within-participant mediation and moderated mediation. We also provide a new R-package that allows for an easy implementation of our recommendations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Experiments with More Than One Random Factor: Designs, Analytic Models, and Statistical Power.

Traditional methods of analyzing data from psychological experiments are based on the assumption that there is a single random factor (normally participants) to which generalization is sought. However, many studies involve at least two random factors (e.g., participants and the targets to which they respond, such as words, pictures, or individuals). The application of traditional analytic methods to the data from such studies can result in serious bias in testing experimental effects. In this review, we develop a comprehensive typology of designs involving two random factors, which may be either crossed or nested, and one fixed factor, condition. We present appropriate linear mixed models for all designs and develop effect size measures. We provide the tools for power estimation for all designs. We then discuss issues of design choice, highlighting power and feasibility considerations. Our goal is to encourage appropriate analytic methods that produce replicable results for studies involving new samples of both participants and targets.

Modeling stimulus variation in three common implicit attitude tasks.

We explored the consequences of ignoring the sampling variation due to stimuli in the domain of implicit attitudes. A large literature in psycholinguistics has examined the statistical treatment of random stimulus materials, but the recommendations from this literature have not been applied to the social psychological literature on implicit attitudes. This is partly because of inherent complications in applying crossed random-effect models to some of the most common implicit attitude tasks, and partly because no work to date has demonstrated that random stimulus variation is in fact consequential in implicit attitude measurement. We addressed this problem by laying out statistically appropriate and practically feasible crossed random-effect models for three of the most commonly used implicit attitude measures-the Implicit Association Test, affect misattribution procedure, and evaluative priming task-and then applying these models to large datasets (average N = 3,206) that assess participants' implicit attitudes toward race, politics, and self-esteem. We showed that the test statistics from the traditional analyses are substantially (about 60 %) inflated relative to the more-appropriate analyses that incorporate stimulus variation. Because all three tasks used the same stimulus words and faces, we could also meaningfully compare the relative contributions of stimulus variation across the tasks. In an appendix, we give syntax in R, SAS, and SPSS for fitting the recommended crossed random-effects models to data from all three tasks, as well as instructions on how to structure the data file.

A cross-national analysis of measurement invariance of the Satisfaction With Life Scale.

Measurement invariance of the Satisfaction With Life Scale (SWLS) was examined in probability samples of adults 50-79 years of age living in the United States, England, and Japan. Confirmatory factor analysis modeling was used to test for multigroup measurement invariance of a single-factor structure of the SWLS. Results support a single-factor structure of the SWLS across the 3 countries, with tests of measurement invariance of the SWLS supporting its configural invariance and metric invariance. These results suggest that the SWLS may be used as a single-factor measure of life satisfaction in the United States, England, and Japan, and that it is appropriate to compare correlates of the SWLS in middle-aged and older adults across these 3 countries. However, results provided evidence for only partial scalar invariance, with the intercept for SWLS Item 4 varying across countries. Cross-national comparisons of means revealed a lower mean at the latent variable level for the Japanese sample than for the other 2 samples. In addition, over and above the latent mean difference, the Japanese sample also manifested a significantly lower intercept on Item 4. Implications of the findings for research on cross-national comparisons of life satisfaction in European American and East Asian countries are discussed. (PsycINFO Database Record

Measuring intergroup ideologies: positive and negative aspects of emphasizing versus looking beyond group differences.

Research on interethnic relations has focused on two ideologies, asking whether it is best to de-emphasize social-category differences (colorblind) or emphasize and celebrate differences (multicultural). We argue each of these can manifest with negative outgroup evaluations: Assimilationism demands that subordinate groups adopt dominant group norms to minimize group distinctions; segregationism holds that groups should occupy separate spheres. Parallel versions can be identified for intergender relations. Scales to measure all four ideologies are developed both for ethnicity (Studies 1 and 2) and gender (Studies 3 and 4). Results demonstrate that the ideologies can be reliably measured, that the hypothesized four-factor models are superior to alternative models with fewer factors, and that the ideologies relate as predicted to the importance ascribed to group distinctions, subordinate group evaluations, and solution preferences for intergroup conflict scenarios. We argue that this fourfold model can help clarify theory and measurement, allowing a more nuanced assessment of ideological attitudes.

Replicating studies in which samples of participants respond to samples of stimuli.

In a direct replication, the typical goal is to reproduce a prior experimental result with a new but comparable sample of participants in a high-powered replication study. Often in psychology, the research to be replicated involves a sample of participants responding to a sample of stimuli. In replicating such studies, we argue that the same criteria should be used in sampling stimuli as are used in sampling participants. Namely, a new but comparable sample of stimuli should be used to ensure that the original results are not due to idiosyncrasies of the original stimulus sample, and the stimulus sample must often be enlarged to ensure high statistical power. In support of the latter point, we discuss the fact that in experiments involving samples of stimuli, statistical power typically does not approach 1 as the number of participants goes to infinity. As an example of the importance of sampling new stimuli, we discuss the bygone literature on the risky shift phenomenon, which was almost entirely based on a single stimulus sample that was later discovered to be highly unrepresentative. We discuss the use of both resampled and expanded stimulus sets, that is, stimulus samples that include the original stimuli plus new stimuli.

Perceiving political polarization in the United States: party identity strength and attitude extremity exacerbate the perceived partisan divide.

An important component of political polarization in the United States is the degree to which ordinary people perceive political polarization. We used over 30 years of national survey data from the American National Election Study to examine how the public perceives political polarization between the Democratic and Republican parties and between Democratic and Republican presidential candidates. People in the United States consistently overestimate polarization between the attitudes of Democrats and Republicans. People who perceive the greatest political polarization are most likely to report having been politically active, including voting, trying to sway others' political beliefs, and making campaign contributions. We present a 3-factor framework to understand ordinary people's perceptions of political polarization. We suggest that people perceive greater political polarization when they (a) estimate the attitudes of those categorized as being in the "opposing group"; (b) identify strongly as either Democrat or Republican; and (c) hold relatively extreme partisan attitudes-particularly when those partisan attitudes align with their own partisan political identity. These patterns of polarization perception occur among both Democrats and Republicans.

Categorisation salience and ingroup bias: the buffering role of a multicultural ideology.

The current work sought to test the moderating role of a multicultural ideology on the relationship between categorisation salience and ingroup bias. Accordingly, in one experimental study, we manipulated categorisation salience and the accessibility of a multicultural ideology, and measured intergroup attitudes. Results show that categorisation salience only leads to ingroup bias when a multiculturalism (MC) ideology is not made salient. Thus, MC ideology attenuates the negative effects of categorisation salience on ingroup bias. These results pertain to social psychology in general showing that the cognitive processes should be construed within the framework of ideological contexts.

Statistical power and optimal design in experiments in which samples of participants respond to samples of stimuli.

Researchers designing experiments in which a sample of participants responds to a sample of stimuli are faced with difficult questions about optimal study design. The conventional procedures of statistical power analysis fail to provide appropriate answers to these questions because they are based on statistical models in which stimuli are not assumed to be a source of random variation in the data, models that are inappropriate for experiments involving crossed random factors of participants and stimuli. In this article, we present new methods of power analysis for designs with crossed random factors, and we give detailed, practical guidance to psychology researchers planning experiments in which a sample of participants responds to a sample of stimuli. We extensively examine 5 commonly used experimental designs, describe how to estimate statistical power in each, and provide power analysis results based on a reasonable set of default parameter values. We then develop general conclusions and formulate rules of thumb concerning the optimal design of experiments in which a sample of participants responds to a sample of stimuli. We show that in crossed designs, statistical power typically does not approach unity as the number of participants goes to infinity but instead approaches a maximum attainable power value that is possibly small, depending on the stimulus sample. We also consider the statistical merits of designs involving multiple stimulus blocks. Finally, we provide a simple and flexible Web-based power application to aid researchers in planning studies with samples of stimuli.

Power anomalies in testing mediation.

Two rather surprising anomalies relating to statistical power occur in testing mediation. First, in a model with no direct effect for which the total effect and indirect effect are identical, the power for the test of the total effect can be dramatically smaller than the power for the test of the indirect effect. Second, when there is a direct effect of a causal variable on the outcome controlling for the mediator, the power of the test of the indirect effect is often considerably greater than the power of the test of the direct effect, even when the two are of the same magnitude. We try to explain the reasons for these anomalies and how they affect practice.

Awareness of implicit attitudes.

Research on implicit attitudes has raised questions about how well people know their own attitudes. Most research on this question has focused on the correspondence between measures of implicit attitudes and measures of explicit attitudes, with low correspondence interpreted as showing that people have little awareness of their implicit attitudes. We took a different approach and directly asked participants to predict their results on upcoming Implicit Association Test (IAT) measures of implicit attitudes toward 5 social groups. We found that participants were surprisingly accurate in their predictions. Across 4 studies, predictions were accurate regardless of whether implicit attitudes were described as true attitudes or culturally learned associations (Studies 1 and 2), regardless of whether predictions were made as specific response patterns (Study 1) or as conceptual responses (Studies 2-4), and regardless of how much experience or explanation participants received before making their predictions (Study 4). Study 3 further suggested that participants' predictions reflected unique insight into their own implicit responses, beyond intuitions about how people in general might respond. Prediction accuracy occurred despite generally low correspondence between implicit and explicit measures of attitudes, as found in prior research. Altogether, the research findings cast doubt on the belief that attitudes or evaluations measured by the IAT necessarily reflect unconscious attitudes.

Measurement invariance of the Beck Depression Inventory-Second Edition (BDI-II) across gender, race, and ethnicity in college students.

Measurement invariance of the Beck Depression Inventory-Second Edition (BDI-II) across gender, race, and ethnic groups was evaluated in a large sample of college students, using pooled data from 11 universities from diverse geographical regions in the United States (N = 7,369). Confirmatory factor analysis was used to test the fit of several possible factor structures, and the results from these analyses indicated that the BDI-II was most adequately represented by a hierarchical four-factor structure, composed of three first-order factors and one second-order factor. Results based on analyses of covariance structures indicated there was factorial invariance for this hierarchical four-factor structure across groups, suggesting that the BDI-II provides an assessment of severity of depressive symptoms that is equivalent across gender, race, and ethnicity in college students.

Family functioning and the course of adolescent bipolar disorder.

The symptoms of bipolar disorder affect and are affected by the functioning of family environments. Little is known, however, about the stability of family functioning among youth with bipolar disorder as they cycle in and out of mood episodes. This study examined family functioning and its relationship to symptoms of adolescent bipolar disorder, using longitudinal measures of family cohesion, adaptability, and conflict. Parent- and adolescent-reported symptom and family functioning data were collected from 58 families of adolescents with bipolar disorder (mean age =14.48±1.60; 33 female, 25 male) who participated in a 2-year randomized trial of family-focused treatment for adolescents (FFT-A). Cohesion and adaptability scores did not significantly change over the course of the study. Parent-reported conflict prior to psychosocial treatment moderated the treatment responses of families, such that high-conflict families participating in FFT-A demonstrated greater reductions in conflict over time than low-conflict families. Moreover, adolescent mania symptoms improved more rapidly in low-conflict than in high-conflict families. For all respondents, cohesion, adaptability, and conflict were longitudinally correlated with adolescents' depression scores. Finally, decreases in parent-reported conflict also predicted decreases in adolescents' manic symptoms over the 2-year study. Findings suggest that family cohesion, adaptability, and conflict may be useful predictors of the course of adolescent mood symptoms. Family conflict may be an important target for family intervention in early onset bipolar disorder.