A tripartite model of the psychotherapy relationship: Interrelations among its components and their unfolding across sessions.

The tripartite model of the therapy relationship, which includes the working alliance, real relationship, and transference-countertransference configuration, has been a useful way to conceptualize the complexity of the connection between a therapist and a client. However, little research has focused on the interrelationships between these three components over time. This study sought to replicate the findings of Bhatia and Gelso (2018) by examining the between-person relationships among each of the three elements averaged across all sessions. Additionally, we extended earlier work by examining the within-person relationship between the working alliance, the real relationship, and transference-countertransference with themselves as well as with each of the other elements across sessions. Using 5,931 sessions across 142 clients and 36 therapists, we examined time-ordered associations among the cocreated working alliance, cocreated real relationship, and the therapist-rated transference-countertransference configuration using latent variable dynamic structural equation modeling. Results replicated the findings of Bhatia and Gelso (2018), demonstrating that in one session, the working alliance and the real relationship were positively related, and both the working alliance and the real relationship were negatively related to the transference-countertransference configuration. Regarding the interrelations over time, the findings revealed that the working alliance in the previous session had a significant and positive relationship with real relationship in the current session, and the real relationship in the previous session was related to reduced transference-countertransference in the current session. These findings provide support for complex interrelations among the components over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Wine-Mom Culture, Alcohol Use, and Drinking Motives: A Descriptive Study and Cross-Cultural Exploration of American and British Mothers.

Objective: "Wine-mom" culture, which promotes the idea that women should use alcohol to cope with the stressors of parenting, is pervasive in modern society, yet remains an under-researched variable in the context of women's alcohol use. The present investigation was a descriptive study and cross-cultural exploration (United States vs. United Kingdom) of the association between wine-mom culture (perceptions of wine-mom culture and related behaviors) and various alcohol-related outcomes, parenting experiences, and drinking motives. Methods: This study included 233 American and 233 British mothers recruited through Prolific. Participants completed the study questions/questionnaires in Qualtrics; they completed nine items measuring their perceptions of and engagement with wine-mom culture, the Alcohol Use Disorders Identification Test, the Parental Stress Scale, and the Drinking Motives Questionnaire-Revised, along with questions about their alcohol use and parenting experiences. Results: Our results indicated that although American mothers were more familiar with wine-mom culture than British mothers, the correlations observed were similar for both groups. Some of the wine-mom culture variables were associated with problematic alcohol use and parenting stress. Additionally, wine-mom culture-related behaviors had moderate to strong positive correlations with drinking to cope motives. Conclusion: Our findings suggest that future research should examine the role of wine-mom culture in the perception that alcohol can-or should-be used as a form of self-medication. Other future directions and considerations for this area of study are discussed.

Problematic alcohol use and food and alcohol disturbance in mothers: Examining the role of stress, body dissatisfaction, and wine-mom-consistent drinking.

OBJECTIVE: In recent years, women have significantly closed the alcohol use gender gap-and they are drinking more heavily now than in previous decades (Keyes et al., 2019). Furthermore, "wine-mom" culture (which promotes the use of alcohol to cope with the stressors of parenthood) has become increasingly prevalent in society and may be a factor in mothers' alcohol use. In the present study, we examined wine-mom-consistent drinking (whether one's alcohol use corresponds to that promoted by wine-mom culture) as a moderator in the relationship between psychosocial predictors (stress, body dissatisfaction) and alcohol-related outcomes (problematic alcohol use, food and alcohol disturbance-FAD). METHODS: Participants were mothers (Mage = 40.18, SD = 8.28) recruited through Prolific from both the United States and the United Kingdom (n = 466; 50 % from the US and UK each); they completed the study via a Qualtrics survey. RESULTS: In the models tested, stress interacted with wine-mom-consistent drinking in predicting FAD (alcohol effects and restriction dimensions), and body dissatisfaction interacted with wine-mom-consistent drinking in predicting the FAD restriction dimension. Compared to those who did not endorse wine-mom-consistent drinking, the relationship between the predictors and the FAD dimensions was stronger among participants who endorsed wine-mom-consistent drinking. Body dissatisfaction and wine-mom-consistent drinking also emerged as significant independent predictors in some of the models. CONCLUSION: Wine-mom-consistent drinking is associated with problematic alcohol use and FAD among mothers. Further research is needed to better understand wine-mom culture and related psychosocial factors in mothers' drinking motives and behaviors.

An examination of health locus of control in relation to antibiotic resistance perceptions and antibiotic use behaviors among college students.

Objective: The aim of the present study was to examine the role of health locus of control (HLOC; internal, chance, powerful others) in antibiotic resistance perceptions and antibiotic use behaviors among college students. Participants: Participants were 366 students recruited from the introductory psychology pool at a university in the northeastern United States. Methods: Participants completed the study via Qualtrics in 2015 (October-December). They completed the Multidimensional Health Locus of Control Scale (measuring internal, chance, powerful others HLOC) and questions about their antibiotic use and antibiotic resistance perceptions. Results: Linear regression analyses were employed to examine the role of the HLOC in antibiotic use behaviors and antibiotic resistance perceptions. With the exception of the regression with antibiotic resistance concern as an outcome, powerful others HLOC was the strongest predictor across all models. Conclusions: Antibiotic misuse was prevalent in our sample and powerful others HLOC was associated with problematic antibiotic use.

Illness perceptions, coping, and health-related quality of life among individuals experiencing chronic Lyme disease.

OBJECTIVE: The aim of the present study was to examine illness perceptions and coping in relation to the health-related quality of life (HRQOL) among individuals experiencing chronic Lyme disease (CLD). METHODS: Participants were 82 individuals who had a confirmed diagnosis of Lyme disease and had been experiencing symptoms for 6 months or more. They were recruited through various online mechanisms (e.g., social media, online support groups), and they completed the consent form and questionnaires via Qualtrics. Participants completed questions about their demographics and health status as well as the Illness Perception Questionnaire-Revised (Moss-Morris et al., 2002), the Brief COPE (Carver, 1997), and the 36-item Short Form Health Survey (SF-36; Ware & Sherbourne, 1992). RESULTS: Illness perceptions and coping explained a significant amount of variance in HRQOL. Among the illness perceptions, the consequences and identity dimensions were most strongly associated with HRQOL. Behavioral disengagement and substance use were the coping strategies most strongly associated with the emotional health outcomes. DISCUSSION: Illness perceptions and coping are related to HRQOL among individuals with CLD. Given the increase in Lyme disease incidence and the chronicity of symptoms in some cases, it is critical to continue to examine the psychosocial factors associated with HRQOL in this population.

An examination of the role of social comparison orientation and social norms in drunkorexia engagement.

Drunkorexia is a behavior pattern marked by calorie restriction and/or compensation in relation to alcohol consumption. The aim of the present study was to examine the role of social norms (descriptive, injunctive) and social comparison orientation (SCO; global, alcohol-specific, eating disorder-related) in drunkorexia engagement. Specifically, our research aimed to examine a possible interaction between norms and SCO; we hypothesized that the relationship between social norms and drunkorexia would be moderated by SCO in that the relationship would be stronger among those elevated on SCO. Data were collected from an undergraduate sample (n = 501); participants completed the consent form and questions/questionnaires via Qualtrics. The results indicated that the predictor variables examined were correlated with overall drunkorexia engagement. In the regression models, in terms of main effects, eating disorder-related SCO emerged as the strongest predictor of the drunkorexia dimensions as well as overall drunkorexia engagement. Descriptive norms emerged as the second strongest predictor in the models. Only one interaction was identified; eating disorder-related SCO moderated the relationship between descriptive norms and the bulimia drunkorexia dimension. The simple slopes analysis indicated that descriptive norms was positively predictive of the bulimia drunkorexia dimension only among individuals with average or elevated eating disorder-related SCO. Social comparisons made regarding one's body, eating, or exercise (eating disorder-related) and social norms are potentially important targets for drunkorexia prevention and/or intervention programs. Further research is needed to better understand risk factors for drunkorexia engagement in the college population.

Loneliness and Psychological Distress in Women Diagnosed with Ovarian Cancer: Examining the Role of Self-Perceived Burden, Social Support Seeking, and Social Network Diversity.

The aim of the present study was to examine the role of self-perceived burden, social support seeking, and social network diversity in loneliness and psychological distress among women with ovarian cancer. A cross-sectional design was employed whereby 130 women diagnosed with ovarian cancer, recruited through various online sources (e.g., social media), completed the study via Qualtrics. Participants completed questionnaires that assessed self-perceived burden, social support seeking, social network diversity, loneliness, and psychological distress (anxiety, depressive symptoms). The models examined indicated that there were indirect effects of self-perceived burden and social network diversity on psychological distress via loneliness. Social support seeking was not significant in the models. Loneliness, self-perceived burden, and social network diversity should be of clinical concern among those working to support women with ovarian cancer. Future studies on longitudinal patterns or examining other factors associated with loneliness are needed to better understand the mental health of women with ovarian cancer.

Experiences of women with ovarian cancer during the COVID-19 pandemic: Examining intolerance of uncertainty and fear of COVID-19 in relation to psychological distress.

PURPOSE: Our research aimed to examine the role of intolerance of uncertainty (IU) in psychological distress (PD) among women with ovarian cancer. Fear of COVID-19 (FCOV) was examined as a mediator, and participant health status and the reopening status of their geographic region were examined as moderators. DESIGN: A cross-sectional quantitative design was employed. PARTICIPANTS: Participants (n = 100) were recruited through various online sources and completed the study via Qualtrics. METHODS: Moderated mediation models and post-hoc linear regression analyses were used to determine the role of predictor variables in PD. RESULTS: No significant moderators or mediators were found. Despite a strong correlation between FCOV and IU, both variables explained unique variance in the anxiety and stress models, while FCOV was not significant in the depressive symptoms model. IMPLICATIONS FOR PROVIDERS: Both IU and FCOV should be considered in helping women with ovarian cancer manage their PD during the COVID-19 pandemic.

Examining eating disorder-related social comparison orientation and body dissatisfaction in the relationship between fit ideal internalization and drunkorexia engagement.

The aim of the present study was to examine the relationship between fit ideal internalization and drunkorexia engagement in women. Specifically, in line with the Tripartite Influence Model, we examined the indirect effect of fit ideal internalization on drunkorexia through eating disorder-related social comparison orientation and body dissatisfaction. Data were collected from two samples of women-college undergraduate students (n = 198) and women recruited through Amazon Mechanical Turk (n = 324)-in order to test the model across the two groups. All participants completed the consent forms and then questionnaires via Qualtrics between March and June 2020. The results suggest that fit ideal internalization, body dissatisfaction, and eating disorder-related social comparison orientation are linked to drunkorexia. More specifically, multigroup path analyses indicated that there was an indirect effect of fit ideal internalization on drunkorexia via eating disorder-related social comparison orientation but not through body dissatisfaction. In examining the role of different types of eating disorder-related social comparison orientation (body, eating, exercise) in the model, more nuanced patterns emerged across the samples. Future research examining potential mediators and moderators of the relationship between eating disorder-related social comparison orientation and drunkorexia would be beneficial in expanding this area of study.

Examining the role of body esteem and sensation seeking in drunkorexia behaviors.

PURPOSE: The purpose of the present study was to examine the role of body esteem (BE), sensation seeking (SS), and their interaction in drunkorexia, a behavior pattern marked by calorie restriction/compensation in the context of alcohol consumption. While previous research on drunkorexia has focused on a range of variables, the present study examined two novel variables and their potential interaction: body esteem (weight, appearance) and sensation seeking. METHODS: A sample of college students (n =488) completed the Body Esteem Scale for Adolescents and Adults, the Brief Sensation Seeking Scale, and the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale, which measures overall drunkorexia engagement as well as four dimensions: alcohol effects, bulimia, dietary restraint and exercise, and restriction. RESULTS: Moderated linear regression analyses indicated that SS and BE (weight, appearance) did not interact in predicting drunkorexia. Rather, only main effects were observed; SS, weight esteem (WE), and appearance esteem (AE) were significant in predicting overall drunkorexia engagement. In terms of the drunkorexia dimensions, AE was a significant predictor in the alcohol effects, dietary restraint and exercise, and restriction models. WE was significant in the dietary restraint and exercise model as well as the restriction model. SS was a significant predictor across all drunkorexia dimensions. CONCLUSIONS: Our findings suggest that both elevated SS and lowered BE are associated with drunkorexia engagement. Implications for practice are discussed. Drunkorexia is a complex and multifaceted behavior pattern; therefore, further research is needed in this area of study. LEVEL OF EVIDENCE: Level V (descriptive study).

Economic instability and household chaos relate to cortisol for children in poverty.

The present study investigated relations among various aspects of economic adversity and cortisol levels for young children facing economic hardship. Specifically, the study examined relations to cortisol for variables representing family income, material hardship, financial strain, economic instability, and household chaos. Participants were 374 children, ages 3-5 years, who attended a Head Start preschool, as well as their primary caregivers. Nearly all children lived in households classified as poor or low-income, defined as less than two times the federal poverty threshold. Caregivers completed interviews about family demographics and economic adversity at the beginning of the school year. Child salivary cortisol was sampled in duplicate on two weekday mornings at the end of the school year. We hypothesized that economic instability would show direct statistical effects on child cortisol as well as indirect effects via household chaos. A structural equation model that corresponded to this hypothesis showed adequate fit for the sample data and revealed a statistically significant indirect effect of economic adversity on child cortisol via economic instability and household chaos, as well as statistically significant direct effects of economic instability and chaos on child cortisol, and a significant indirect effect of economic instability on cortisol via household chaos. Implications concern understanding mechanisms of poverty risk, including the impact of instability and chaos on stress physiology, and promoting physiological regulation for children facing economic hardship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Intolerance of uncertainty, social support, and loneliness in relation to anxiety and depressive symptoms among women diagnosed with ovarian cancer.

OBJECTIVE: Intolerance of uncertainty (IU) is a trait variable that captures an individual's lack of tolerance for unknown outcomes and events. Positive correlations between IU and mental health symptoms have been observed in various populations, while social variables (social support and decreased loneliness) seem to serve as protective factors against psychological distress among individuals with cancer. The present study examined the moderation effect of social support and loneliness in the relationship between IU and mental health symptoms among women diagnosed with ovarian cancer. METHODS: This study was a cross-sectional design involving 131 women diagnosed with ovarian cancer recruited through social media and other online sources. Participants completed questionnaires that assessed their IU (prospective and inhibitory), anxiety symptoms, depressive symptoms, social support, and loneliness. Moderated regression analyses were applied to test the hypothesis that low social support and high loneliness would exacerbate the relationship between IU and symptoms of anxiety and depression. RESULTS: The hypothesized moderation effects (social support × IU, loneliness × IU) were not supported in the anxiety and depressive symptoms models. Post hoc linear regression analyses indicated that IU and loneliness were predictive of depressive and anxiety symptoms. Loneliness was the strongest predictor in both the anxiety and depressive symptoms models, followed by IU. CONCLUSIONS: The findings indicate that loneliness and IU-particularly inhibitory IU-are important considerations in understanding mental health symptoms among women diagnosed with ovarian cancer. Addressing both loneliness and IU may be an important avenue in clinical settings.

Improving Measurement of Trait Competitiveness: A Rasch Analysis of the Revised Competitiveness Index With Samples From New Zealand and US University Students.

Measuring competitiveness is necessary to fully understand variables affecting student learning. The 14-item Revised Competitiveness Index has become a widely used measure to assess trait competitiveness. The current study reports on a Rasch analysis to investigate the psychometric properties of the Revised Competitiveness Index and to improve its precision for international comparisons. Students were recruited from medical studies at a university in New Zealand, undergraduate health sciences courses at another New Zealand university, and a psychology undergraduate class at a university in the United States. Rasch model estimate parameters were affected by local dependency and item misfit. Best fit to the Rasch model (χ2(20) = 15.86, p = .73, person separation index = .95) was obtained for the Enjoyment of Competition subscale after combining locally dependent items into a subtest and discarding the highly misfitting Item 9. The only modifications required to obtain a suitable fit (χ2(25) = 25.81, p = .42, person separation index = .77) for the Contentiousness subscale were a subtest to combine two locally dependent items and splitting this subtest by country to deal with differential item functioning. The results support reliability and internal construct validity of the modified Revised Competitiveness Index. Precision of the measure may be enhanced using the ordinal-to-interval conversion algorithms presented here, allowing the use of parametric statistics without breaking fundamental statistical assumptions.

Rasch analysis of the Perceived Stress Scale: Transformation from an ordinal to a linear measure.

Rasch analysis was conducted to enhance the precision of the widely used 10-item Perceived Stress Scale using two datasets (n = 450 each) randomly selected from samples of the New Zealand general population (n = 1102), New Zealand university students (n = 479) and US university students (n = 396). The best Rasch model fit (χ2(27) = 29.92, p = .36), good person separation reliability (.80) and coverage (98%) of the sample by the scale items were achieved when locally dependent items were combined into subtests. These findings support reliability and internal structural validity of the 10-item Perceived Stress Scale. The instrument precision can be further improved using the ordinal-to-linear conversion tables published here.

A Comparative, Multi-national Analysis of the Quality of Life and Learning Factors of Medical and Non-medical Undergraduate Students.

OBJECTIVE: This study compares data from two medical student cohorts early in their training from New Zealand and Hong Kong and then makes further comparisons with a non-medical group. METHODS: Questionnaires obtained information regarding educational site (universities situated in New Zealand, Hong Kong, and USA), gender, age, motivational beliefs, quality of life, and competitiveness. The study was split into two phases. The first phase focused on measuring and comparing the learning and wellbeing variables of two medical student cohorts. The second phase focussed on making further comparisons with non-medical student groups. RESULTS: Responses were elicited from 353 students in medically oriented courses and 688 students with a non-medical orientation. For phase 1, the results indicated differences between the two medical student groups on measures of self-efficacy, intrinsic value, enjoyment of competition, and physical quality of life. For phase 2, differences between the medical and non-medical student groups were noted for self-efficacy, intrinsic value, enjoyment of competition, contentiousness, and physical and social quality of life. CONCLUSIONS: The results provide insights into medical and non-medical students' learning and wellbeing experiences from multi-national, multi-discipline perspectives. The results suggest that wellbeing issues of students are likely context-specific and moderated by region, curriculum, gender, and culture.

Development and initial validation of the appropriate antibiotic use self-efficacy scale.

OBJECTIVE: While there are various medication self-efficacy scales that exist, none assess self-efficacy for appropriate antibiotic use. The Appropriate Antibiotic Use Self-Efficacy Scale (AAUSES) was developed, pilot tested, and its psychometric properties were examined. METHODS: Following pilot testing of the scale, a 28-item questionnaire was examined using a sample (n = 289) recruited through the Amazon Mechanical Turk platform. Participants also completed other scales and items, which were used in assessing discriminant, convergent, and criterion-related validity. Test-retest reliability was also examined. RESULTS: After examining the scale and removing items that did not assess appropriate antibiotic use, an exploratory factor analysis was conducted on 13 items from the original scale. Three factors were retained that explained 65.51% of the variance. The scale and its subscales had adequate internal consistency. The scale had excellent test-retest reliability, as well as demonstrated convergent, discriminant, and criterion-related validity. CONCLUSIONS: The AAUSES is a valid and reliable scale that assesses three domains of appropriate antibiotic use self-efficacy. PRACTICE IMPLICATIONS: The AAUSES may have utility in clinical and research settings in understanding individuals' beliefs about appropriate antibiotic use and related behavioral correlates. Future research is needed to examine the scale's utility in these settings.

Women with Ovarian Cancer: Examining the Role of Social Support and Rumination in Posttraumatic Growth, Psychological Distress, and Psychological Well-being.

The present study examined the role of social support and rumination (deliberate vs. intrusive) in posttraumatic growth (PTG), psychological distress (PD), and psychological well-being (PWB) among women with ovarian cancer. Sixty-seven women who had experienced ovarian cancer were recruited through social media and cancer-related websites, and completed an online survey. Contrary to hypotheses, results indicated that social support was not predictive of PTG, and the mediation of rumination was not significant in the regression of social support on PTG. Social support was, however, positively correlated with the Relating to Others domain of PTG. Deliberate rumination was positively predictive of PTG, and intrusive rumination was positively predictive of PD and negatively predictive of PWB. Social support was negatively predictive of PD, and positively predictive of PWB. Results are discussed with reference to clinical implications and future research needed in understanding the ovarian cancer experience.

Quality of life and mental health among women with ovarian cancer: examining the role of emotional and instrumental social support seeking.

The purpose of the present study was to examine the role of emotional and instrumental social support seeking in the quality of life (QOL) and mental health of women with ovarian cancer. Participants were recruited through the Pennsylvania Cancer Registry, and one hundred women took part in a mail questionnaire that collected information on their demographics, medical status, social support seeking, QOL and mental health including anxiety, depression and stress. Hierarchical linear regression analyses were conducted to assess the influence of emotional and instrumental social support seeking on QOL and mental health. After controlling for remission status, greater emotional social support seeking was predictive of higher overall QOL, social/family QOL, functional QOL and lower depression scores. Instrumental social support seeking was not significant in the models. The results illustrate that social support seeking as a coping mechanism is an important consideration in the QOL and mental health of women with ovarian cancer. Future studies should examine the psychological and behavioral mediators of the relationship to further understand the QOL and mental health of women with ovarian cancer.

The role of narcissism in health-risk and health-protective behaviors.

This study examined the role of narcissism in health-risk and health-protective behaviors in a sample of 365 undergraduate students. Regression analyses were used to test the influence of narcissism on health behaviors. Narcissism was positively predictive of alcohol use, marijuana use, and risky driving behaviors, and it was associated with an increased likelihood of consistently having a healthy eating pattern. Narcissism was also positively predictive of physical activity. Results are discussed with reference to the potential short-term and long-term health implications and the need for future research on the factors involved in the relationship between narcissism and health behaviors.

Benthic microalgae serve as the major food resource for porcelain crabs (Petrolisthes spp.) in oyster reefs: gut content and pigment evidence1.

Suspension-feeding porcelain crabs (Petrolisthes spp.) are often the most abundant decapod crustaceans in oyster reef habitat. Analysis of water column and subtidal algal biomass from three Texas estuaries suggests that planktonic food resources are insufficient for porcelain crab growth. Pigment composition of porcelain crab muscle and digestive track contents included the diatom pigment fucoxanthin and cyanobacterial pigment canthaxanthin with digestive track samples containing attached (adnate) benthic diatoms as well as benthic cyanobacteria not found in the water column. Feeding appendages on porcelain crabs include numerous cirri with serrated edges as well as fewer more brush-like longer units. Benthic food resources are in sufficient supply to support porcelain crab biomass.