Patient attachment and reflective functioning as predictors for therapist in-session feelings.

Therapists' in-session feelings in psychotherapy can be seen as indications of the development of the therapeutic relationship and the therapeutic process. To manage them appropriately, it is important to know to what extent they may be influenced by patients' pretreatment characteristics. This study aims to improve the understanding of therapists' emotional reactions in the psychotherapeutic setting by investigating if patients' pretreatment mentalization ability and attachment style predicted therapist in-session feelings. In a sample of 87 therapy dyads treated with interpersonal psychotherapy and cognitive behavioral therapy for depression, patient attachment was measured using self-reported Experiences in Close Relationships (ECR) and mentalization using Reflective Functioning (RF). ECR and RF were hypothesized to predict therapist feelings measured by the Feeling Word Checklist-24 at different treatment phases over the full course of treatment. Treatment method, patient age, gender, and pretreatment depression were evaluated as potential confounders. Multilevel modeling was used to analyze the data. Lower RF in patients predicted more negative therapist feelings in the mid- to late-treatment phases and less positive feelings in the late-treatment phase. Self-reported attachment anxiety or avoidance did not predict therapist feelings. Findings indicate that patients' ability to mentalize is important to consider when conducting psychotherapy, as it can influence therapists' feelings in the therapeutic process. Limitations of the present study's approach are discussed, and directions for future research are considered. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Fear and anxiety differ in construal level and scope.

The fear-anxiety distinction has been extensively discussed and debated among emotion researchers. In this study, we tested this distinction from a social-cognitive perspective. Drawing on construal level theory and regulatory scope theory, we examined whether fear and anxiety differ in their underlying level of construal and scope. Results from a preregistered autobiographical recall study (N = 200) that concerned either a fear situation or an anxiety situation and a large dataset from Twitter (N = 104,949) indicated that anxiety was associated with a higher level of construal and a more expansive scope than fear. These findings support the notion that emotions serve as mental tools that deal with different challenges. While fear prompts people to seek immediate solutions to concrete threats in the here and now (contractive scope), anxiety prompts them to deal with distant and unknown threats that require more expansive and flexible solutions (expansive scope). Our study contributes to a growing literature on emotions and construal level and points to interesting avenues for further research.

Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome.

BACKGROUND: European treatment guidelines recommend prasugrel over ticagrelor for treating patients with non-ST-elevation acute coronary syndrome (ACS), prompting several Swedish administrative regions to transition from ticagrelor to prasugrel as the preferred treatment for patients with ACS. We aim to systematically evaluate this transition to determine the relative efficacy of prasugrel versus ticagrelor in a real-world cohort of patients with ACS. STUDY DESIGN AND OBJECTIVES: The SWITCH SWEDEHEART trial is a prospective, multicenter, open-label, cross-sectional, stepped-wedge cluster-randomized clinical trial, in which administrative regions in Sweden will constitute the clusters. At the start of the study, all clusters will use ticagrelor as the P2Y12 inhibitor drug of choice for ACS. The order in which the clusters will implement the transition from ticagrelor to prasugrel will be randomly assigned. Every 9 months, 1 cluster will switch from ticagrelor to prasugrel as the P2Y12 inhibitor of choice for patients with ACS. The primary endpoint is the composite 1-year rate of the death, stroke, or myocardial infarction. CONCLUSIONS: The SWITCH SWEDEHEART study will provide an extensive randomized comparison between ticagrelor and prasugrel. Novel therapies are frequently costly and supported by evidence from few or small studies, and systematic evaluation after the introduction is rare. This study will establish an important standard for introducing and evaluating the effects of health care changes within our societies.

Ambivalent stereotypes link to peace, conflict, and inequality across 38 nations.

A cross-national study, 49 samples in 38 nations (n = 4,344), investigates whether national peace and conflict reflect ambivalent warmth and competence stereotypes: High-conflict societies (Pakistan) may need clearcut, unambivalent group images distinguishing friends from foes. Highly peaceful countries (Denmark) also may need less ambivalence because most groups occupy the shared national identity, with only a few outcasts. Finally, nations with intermediate conflict (United States) may need ambivalence to justify more complex intergroup-system stability. Using the Global Peace Index to measure conflict, a curvilinear (quadratic) relationship between ambivalence and conflict highlights how both extremely peaceful and extremely conflictual countries display lower stereotype ambivalence, whereas countries intermediate on peace-conflict present higher ambivalence. These data also replicated a linear inequality-ambivalence relationship.

How a terror attack affects right-wing authoritarianism, social dominance orientation, and their relationship to torture attitudes.

Self-reported level of right-wing authoritarianism (RWA), the two facets of social dominance orientation (SDO-Dominance and SDO-Egalitarianism) and pro-torture attitudes were measured both in the immediate aftermath (terror salience, N = 152) of the terror attacks in Paris and Brussels and when terrorism was not salient (non-salience, N = 140). Results showed that RWA and pro-torture attitudes, but not SDO-Dominance and SDO-Egalitarianism, were significantly higher immediately after. Furthermore, RWA and SDO both predicted pro-torture attitudes more strongly under terror salience. We argue that the reason why RWA is higher under terror salience is a response to external threat, and that SDO-Dominance may be more clearly related to acceptance of torture and other human-rights violations, across context. Future research on the effects of terror-related events on sociopolitical and pro-torture attitudes should focus on person-situation interactions and also attempt to discriminate between trait and state aspects of authoritarianism.

Self-control depletion impairs goal maintenance: A meta-analysis.

Initial exertion of self-control has been suggested to impair subsequent self-regulatory performance. The specific cognitive processes that underlie this ego depletion effect have rarely been examined. Drawing on the dual-process theory of executive control (Engle & Kane, ; Kane & Engle, ), the current meta-analysis revealed that initial self-control exertion impairs participants' capacities of maintaining the task goal but its effect on capacities of resolving response competition is in need of further investigation. Our results are more consistent with recent theoretical views that consider ego depletion as a switch cost and a result arising from reduced motivation to engage in further self-control.

Implementation of a new guideline in cardiovascular secondary preventive care: subanalysis of a randomized controlled trial.

BACKGROUND: Cardiovascular secondary preventive recommendations are often not reached. We investigated whether a nurse-led telephone-based follow-up could improve the implementation of a new guideline within a year after its release. METHODS: In February 2013, a new secondary preventive guideline for diabetic patients was released in the county of Jämtland, Sweden. It included a changed of the low-density lipoprotein cholesterol (LDL-C) target value from <2.5 mmol/L to <1.8 mmol/L. In the Nurse-Based Age-Independent Intervention to Limit Evolution of Disease (NAILED) trial, patients with an acute coronary syndrome, stroke, or transient ischemic attack were randomized to secondary preventive care with nurse-based telephone follow-up (intervention) or usual care (control). Patient data were obtained from the NAILED trial to study the implementation of the new LDL-C guideline by comparing telephone follow-up with usual care. The Mann-Whitney U-test was used for continuous variables, and Person's χ (2) test was used for categorical variables to assess between-group differences. RESULTS: Out of the 1267 patients that entered the study period, 101 intervention and 100 control patients with diabetes fulfilled the inclusion criteria and completed the study period. Before the guideline change, 96 % of the intervention patients and 70 % of the control patients reached the target LDL-C value (p < 0.001). After the guideline change, the corresponding respective proportions were 65 % and 36 % (p < 0.001). The main reason that intervention patients did not achieve the target LDL-C value was that they received full-dose treatment; for control patients, the main reason was that medication was not adjusted, for an unknown reason. CONCLUSIONS: One year after a change in the cardiovascular secondary preventive guideline, nurse-based telephone follow-up performed better than usual care to implement the new recommendation. TRIAL REGISTRATION: ISRCTN registry; ISRCTN96595458 (date of registration 10 July 2011) and ISRCTN23868518 (date of registration 13 May 2012).

Getting along or ahead: Effects of gender identity threat on communal and agentic self-presentations.

When faced with a threat to gender identity, people may try to restore their gender status by acting in a more gender-typical manner. The present research investigated effects of gender identity threat on self-presentations of agentic and communal traits in a Swedish and an Argentine sample (N = 242). Under threat (vs. affirmation), Swedish women deemphasized agentic traits (d [95% CI] = -0.41 [-0.93, 0.11]), Argentine women increased their emphasis on communal traits (d = 0.44 [-0.08, 0.97]), and Argentine men increased their emphasis on agentic traits (d = 0.49 [-0.03, 1.01]). However, Swedish men did not appear to be affected by the threat regarding agentic (d = 0.04 [-0.47, 0.55]) or communal traits (d = 0.23 [-0.29, 0.74]). The findings are to be considered tentative. Implications for identity threat research are discussed.

Cardiovascular secondary prevention in high-risk patients: a randomized controlled trial sub-study.

BACKGROUND: Enhanced cardiovascular secondary preventive follow-up is needed to improve adherence to recommended low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) levels. Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) have a high risk of recurrent events. Secondary prevention is therefore essential in these patients. METHODS: Patients with acute coronary syndrome, stroke, or transient ischemic attack were randomized to nurse-based telephone follow-up (intervention) or usual care (control). LDL-C and BP were measured at 1 month (baseline) and 12 months post-discharge. Intervention patients with above-target values at baseline received medication titration to achieve treatment goals. Values measured for control patients were given to the patient's general practitioner for assessment. RESULTS: The final analyses included 225 intervention and 215 control patients with DM or CKD. Among patients with above-target baseline values, the following 12-month values were recorded for intervention and control patients, respectively: LDL-C, 2.2 versus 3.0 mmol/L (p < 0.001); and median systolic BP (SBP), 140 versus 145 mmHg (p = 0.26). Among patients with above-target values at baseline, 52.3 % of intervention patients reached target LDL-C values at 12 months versus 21.3 % of control patients (absolute difference of 30.9 %, 95 % CI 16.1 to 43.8 %), and there was a non-significant trend of more intervention patients reaching target SBP (49.4 % versus 36.8 %; absolute difference of 12.6 %, 95 % CI -1.7 to 26.2 %). CONCLUSIONS: Cardiovascular secondary prevention with nurse-based telephone follow-up was more effective than usual care in improving LDL-C levels 12 months after discharge for patients with DM or CKD. TRIAL REGISTRATION: ISRCTN registry; ISRCTN96595458 (date of registration 10 July 2011) and ISRCTN23868518 (date of registration 13 May 2012).

The risk of ischemic stroke after an acute myocardial infarction in patients with decreased renal function.

BACKGROUND: Data on the incidence, trends over time and predictors of ischemic stroke after an acute myocardial infarction (AMI) are sparse for patients with chronic kidney disease (CKD). METHODS: Data for unselected AMI patients were obtained from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) between 2003 and 2010. Patients with and without CKD were compared. Multiple logistic regression was performed to identify predictors of ischemic stroke during the hospitalization for AMI, Kaplan-Meier analysis was used to analyze the 1-year postdischarge ischemic stroke trends over time and Cox regression analysis was used to identify predictors. RESULTS: Of 118,434 AMI patients, 40,679 had CKD. The CKD patients had more extensive previous cardiovascular disease and received less reperfusion and secondary preventive therapies than the patients without CKD. An inhospital ischemic stroke occurred in 2.3 and 1.2% of CKD and non-CKD patients, respectively. The incidence of ischemic stroke during hospitalization for AMI was stable during the study period. The occurrence of ischemic stroke after hospital discharge decreased between 2003-2004 and 2009-2010 from 4.1 to 2.5% in CKD patients and from 2.0 to 1.3% in non-CKD patients, respectively. Percutaneous coronary intervention (PCI) and statins were independently associated with a reduced risk of stroke after discharge from hospital. CONCLUSIONS: Ischemic stroke is a more common complication after an AMI in CKD patients than in non-CKD patients, but the risk has decreased in recent years. The increased use of PCI and statins may have contributed to this reduction.

Why Forced-Choice and Likert Items Provide the Same Information on Personality, Including Social Desirability.

The forced-choice response format is often considered superior to the standard Likert-type format for controlling social desirability in personality inventories. We performed simulations and found that the trait information based on the two formats converges when the number of items is high and forced-choice items are mixed with regard to positively and negatively keyed items. Given that forced-choice items extract the same personality information as Likert-type items do, including socially desirable responding, other means are needed to counteract social desirability. We propose using evaluatively neutralized items in personality measurement, as they can counteract social desirability regardless of response format.

Social desirability in personality inventories: symptoms, diagnosis and prescribed cure.

An analysis of social desirability in personality assessment is presented. Starting with the symptoms, Study 1 showed that mean ratings of graded personality items are moderately to strongly linearly related to social desirability (Self Deception, Impression formation, and the first Principal Component), suggesting that item popularity may be a useful heuristic tool for identifying items which elicit socially desirable responding. We diagnose the cause of socially desirable responding as an interaction between the evaluative content of the item and enhancement motivation in the rater. Study 2 introduced a possible cure; evaluative neutralization of items. To test the feasibility of the method lay psychometricians (undergraduates) reformulated existing personality test items according to written instructions. The new items were indeed lower in social desirability while essentially retaining the five factor structure and reliability of the inventory. We conclude that although neutralization is no miracle cure, it is simple and has beneficial effects.

Bidirectional correction in social judgments: how a cue to the risk of bias causes more favorable ratings of some groups but less favorable of others.

Correction of judgments of people of different ethnicities and sexes was explored by exposing participants to cues to the risk of making biased judgments (from explicit warnings to subtle hints). In three experiments, a three-way interaction was revealed, where the effect of a cue to bias varied as a function of both the ethnicity and sex of the target person. Some targets (White males) were generally rated less favorably when judges were reminded of bias, whereas other targets (Black males, Middle Eastern males and White females) were generally rated more favorably, indicating bidirectional correction. Finally, a normative account of the results was explored. In a pattern consistent with the experimental results, it was considered more important to avoid overrating White men than all other groups, and more important to avoid underrating all other groups than White men. The results are discussed in relation to theories of correction and intergroup bias.

"Programming Is Not That Hard!" When a Science Center Visit Increases Young Women's Programming Ability Beliefs.

To increase engagement with science and technology, young people around the world are encouraged to attend activities at science centers. But how effective are these activities? Since women have weaker ability beliefs and interest in technology than men, it is especially important to learn how science center visits affect them. In this study, we tested if programming exercises offered to middle school students by a Swedish science center would increase ability beliefs and interest in programming. Students in grades 8 and 9 (n = 506) completed a survey before and after visiting the science center, and their ratings were compared to a wait-list control group (n = 169). The students participated in block-based, text-based, and robot programming exercises developed by the science center. The results showed that programming ability beliefs increased for women, but not men, and that interest in programming decreased for men, but not women. The effects persisted at a follow-up (2-3 months). The young men reported stronger ability beliefs and interest than the young women at all timepoints. The results imply that science center activities can make programming feel less hard, but adaptations may be needed to also increase interest. Supplementary Information: The online version contains supplementary material available at 10.1007/s41979-023-00094-w.

Company norms affect which traits are preferred in job candidates and may cause employment discrimination.

This study investigated a possible mechanism behind employment discrimination. Participants completed a recruitment task where emphasis on cohesion (employees should "fit in") versus fairness (everybody should be treated equally) was manipulated by describing the norms of a fictitious company differently. There was a comparatively stronger preference in the cohesion condition for traits and interview questions related to social competence (e.g., friendliness, gregariousness, empathy). Furthermore, participants in the cohesion condition primarily pictured socially competent employees, whereas those in the fairness condition primarily pictured employees possessing productivity-related characteristics (e.g., education, experience, and talent). The norm effect was moderated by participants' awareness of the applicants' ethnicity. When expecting applicants with foreign backgrounds, participants in the cohesion condition showed increased preference for selection methods related to social competence. Implications for recruitment practices are discussed.

The intent and extent of collective threats: A data-driven conceptualization of collective threats and their relation to political preferences.

The purpose of the present article is to systematically investigate how people perceive collective threat and how such threat perceptions relate to political preferences. Existing threat taxonomies are mostly derived from top-down analyses and little attempt has been made to examine bottom-up how people spontaneously perceive threats. One area where this is of central importance is the relationship between political preferences and threat perception. Prevailing theories in social psychology primarily study security and stability threats and conclude that conservatives are more sensitive to threats than liberals. Other perspectives, however, have criticized this position and maintain that the relationship between threat and political preferences depends on how both constructs are defined. To resolve this issue, we carried out a systematic, data-driven investigation of how collective threats are perceived. In five preregistered, data-driven studies, carried out on representative cross-cultural samples (aggregate N = 24,341), we show that people tend to categorize collective threats along two dimensions-their intent (omission/commission) and extent (local/global). We show that whereas liberals are more concerned than conservatives by omission-based and global threats, conservatives are more concerned than liberals by commission-based and local threats. These results suggest that collective threat is a multidimensional construct and that political leftists and rightists do not necessarily differ in the extent to which they perceive threats, but rather in the way they prioritize different threats facing society. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Stereotype threat in salary negotiations is mediated by reservation salary.

Women are stereotypically perceived as worse negotiators than men, which may make them ask for less salary than men when under stereotype threat (Kray et al., 2001). However, the mechanisms of stereotype threat are not yet properly understood. The current study investigated whether stereotype threat effects in salary negotiations can be explained by motivational factors. A total of 116 business students negotiated salary with a confederate and were either told that this was diagnostic of negotiating ability (threat manipulation) or not. Measures of minimum (reservation) and ideal (aspiration) salary goals and regulatory focus were collected. The finding (Kray et al., 2001) that women make lower salary requests than men when under stereotype threat was replicated. Women in the threat condition further reported lower aspiration salary, marginally significantly lower reservation salary and less eagerness/more vigilance than men. Reservation salary mediated the stereotype threat effect, and there was a trend for regulatory focus to mediate the effect. Thus, reservation salary partly explains why women ask for less salary than men under stereotype threat. Female negotiators may benefit from learning that stereotype threat causes sex-differences in motivation.

In-group ratings are affected by who asks and how: interactive effects of experimenter group-membership and response format.

In three experiments, participants rated how well a number of adjectives described their in-group (e.g. kind-hearted, helpful, intelligent, efficient, etc.). In Experiment 1, females were found to rate their ingroup (females) more favorably when reporting verbally to female (rather than male) experimenters. This finding was further explored in two subsequent experiments where response format (written vs. verbal) was also manipulated. Both experiments revealed an interaction such that ethnic Swedes rated their in-group (Swedes) the most favorably when reporting verbally to an in-group experimenter and the least favorably when reporting verbally to a Middle Eastern experimenter. Results are discussed in relation to correction and contextual activation of social norms.

Fear From Afar, Not So Risky After All: Distancing Moderates the Relationship Between Fear and Risk Taking.

A growing line of research has shown that individuals can regulate emotional biases in risky judgment and decision-making processes through cognitive reappraisal. In the present study, we focus on a specific tactic of reappraisal known as distancing. Drawing on appraisal theories of emotion and the emotion regulation literature, we examine how distancing moderates the relationship between fear and risk taking and anger and risk taking. In three pre-registered studies (N total = 1,483), participants completed various risky judgment and decision-making tasks. Replicating previous results, Study 1 revealed a negative relationship between fear and risk taking and a positive relationship between anger and risk taking at low levels of distancing. Study 2 replicated the interaction between fear and distancing but found no interaction between anger and distancing. Interestingly, at high levels of distancing, we observed a reversal of the relationship between fear and risk taking in both Study 1 and 2. Study 3 manipulated emotion and distancing by asking participants to reflect on current fear-related and anger-related stressors from an immersed or distanced perspective. Study 3 found no main effect of emotion nor any evidence of a moderating role of distancing. However, exploratory analysis revealed a main effect of distancing on optimistic risk estimation, which was mediated by a reduction in self-reported fear. Overall, the findings suggest that distancing can help regulate the influence of incidental fear on risk taking and risk estimation. We discuss implications and suggestions for future research.

Stereotype Content at the Intersection of Gender and Sexual Orientation.

According to the Stereotype Content Model (SCM), the content of stereotypes differs on two dimensions: communion and agency. Research shows that for stereotypes about the general gender categories of "women" and "men," there is an ambivalent pattern of communion and agency, where high levels on one dimension are associated with low levels on the other. For sexual minority stereotypes, a gender inversion has been found, whereas homosexual women are seen as more similar to men in general than to women in general, whereas homosexual men are seen as more similar to women in general than to men in general. However, there is limited research on how stereotype content for general groups relate to stereotype content for subgroups with intersecting category memberships. This research addresses this gap by investigating stereotype content at the intersection of gender and sexual orientation, including stereotype content for general gender groups, heterosexual groups, homosexual groups, and bisexual groups. In Study 1, a community sample from Sweden (N = 824) rated perceived communion and agency for women and men in general, as well as hetero-, homo-, and bisexual women and men. In Study 2, a nationally representative Swedish sample (N = 424) performed the same rating task, and in addition completed Single-Category IATs (SC-IATs) for warmth and competence. Results from both studies show that the stereotype content for the general categories "women" and "men" overlap with the stereotype content for heterosexual same-gender targets. Homosexual and bisexual groups were rated as more similar to their non-congruent gender category than same gender heterosexual categories were, but stereotype content for sexual minority groups did not overlap with either general gender categories, thus showing only incomplete gender inversion of stereotype content. Implicit associations between "women" and "warmth" were significantly stronger than associations between "men" and "warmth." There were no other significant relations between implicit associations to warmth/competence and gender or sexual orientation. Theoretical and methodological implications for future research into intersectional stereotype content are presented, including how the findings inform the co-dependent relationship between a binary gender structure and a heteronormative ideology.