Fear of Incompetence in Family Caregivers and Dementia Care Transitions.

Research on interpersonal interaction dynamics in relationships between persons with dementia and their family caregivers has been limited. We examine the role of these dynamics in decisions to transition a family member from home care to congregate care, with a particular focus on the role of fear of incompetence. Fear of incompetence is the fear of being unable to interact, communicate in a meaningful way, or take care of a close family member with dementia. In this study (N = 350 family caregivers), perceived negative changes in the family member with dementia predicted increased perceived dependency, which predicted both increased caregiver burden and greater fear of incompetence in caregivers, which, in turn, predicted stronger care transition desire. Strategies should be aimed not only at reducing dependency of the care recipient but also teaching family caregivers interaction skills that decrease their fear of interactional incompetence and thus promote home care continuation.

An Empirical Investigation of Variations in Outcomes Associated with Heterosexual Adults' Most Recent Mixed-Sex Threesome Experience.

Research reveals that a substantial proportion of North American adults report interest in and experience with mixed-sex threesomes (MSTs; sexual activity involving three people at the same time in which persons of more than one sex are present). Despite the prevalence of MST participation, little is known about the outcomes of MST experiences. Thus, the current study assessed MST outcomes using various metrics including the extent to which one's most recent MST met expectations, the likelihood of participating in the MST again, and whether an orgasm was experienced. In addition, the extent to which one's sex, the sex of those involved, and the inclusion of one's romantic partner impacted outcomes was examined. Data from 276 heterosexual adults (217 men, 59 women) revealed that, overall, adults report fairly positive outcomes from their most recent MST and that males reported more positive outcomes than did females (particularly when engaging in a MST with two members of the other sex). In addition, MSTs involving one's romantic partner resulted in more positive outcomes than did those with casual partners. These results confirm that MSTs can be a satisfying experience particularly for heterosexual males and those participating with a romantic partner. Implications for educators looking to destigmatize various forms of nonmonogamies and for practitioners who intend to assist adults interested in safely exploring multi-person sexual behavior are discussed.

An Experimental Investigation of Variations in Judgments of Hypothetical Males and Females Initiating Mixed-Gender Threesomes: An Application of Sexual Script Theory.

Although many young adults are interested in mixed-gender threesomes (MGTs), little research has assessed attitudes toward them. Yet, MGTs offer a rare context to investigate how consensually nonmonogamous sexual encounters and involvement with same-sex others influence attitudes. Thus, by adopting sexual script theory as a framework, the current study compared three dimensions of character judgments (cognitive abilities, morality, partner quality) and assumptions about the sexual history of hypothetical males and females who initiated a MGT (two females and one male; two males and one female) or mixed-sex dyadic sexual activity with a casual or committed partner. To do so, a between-subject design was adopted in which 690 U.S. adults (405 women, 285 men) evaluated a hypothetical initiator described in one of 12 vignettes. On average, participants made neutral judgments about the initiator, yet those initiating dyadic sexual behavior were judged more favorably and as having a less extensive sexual history than MGT initiators. Male initiators were judged more favorably than female initiators, particularly by men. Those initiating in the context of a committed relationship were judged as more moral and as higher-quality partners than those initiating within a casual relationship; female (but not male) initiators in the committed context were judged as having a less extensive sexual history than female initiators in the casual context. These results confirm the presence of mononormativity biases and the sexual double standard and have implications for educators and practitioners related to stigma reduction and the promotion of inclusive sexual education.

Exploring Variations in North American Adults' Attitudes, Interest, Experience, and Outcomes Related to Mixed-Gender Threesomes: A Replication and Extension.

Mixed-gender threesomes (MGTs) are a type of consensually nonmonogamous sexual encounter involving three people of more than one gender. Little research has been conducted on MGTs, and what little work does exist is limited to college students, who may actually be less experienced with MGTs than older adults. The present study investigated attitudes toward, interest in, experiences with, and outcomes of MGTs in two samples (college N = 231; online N = 1342), comprised of 907 heterosexual and 666 sexual minority participants in total. Results indicated that participants reported neutral-to-positive attitudes toward and moderate-to-high levels of interest in MGTs (81% indicated some degree of interest). MGTs involving familiar others were preferred to those involving strangers. Men, sexual minority individuals, and participants from the online sample reported more favorable attitudes toward and greater interest in MGTs as compared to women, heterosexual individuals, and participants from the student sample. In addition, 30% of participants indicated having experience with a MGT. Sexual minority individuals reported more experience with MGTs and more positive outcomes than did heterosexual individuals. In addition, on average, participants reported that their MGT experiences "met expectations." Overall, these results indicate that MGTs are a common sexual behavior that often results in positive outcomes, especially among sexual minority individuals. Additional research on this understudied topic is needed, particularly as it relates to outcomes and the role of MGTs in consensually nonmonogamous relationships.

Assessing Implicit Associations with Consensual Non-monogamy Among U.S. Early Emerging Adults: An Application of the Single-Target Implicit Association Test.

Research has demonstrated that implicit and explicit attitudes toward consensual nonmonogamy (CNM; sexually and/or emotionally nonexclusive romantic relationships) are less favorable than those toward monogamy. Although this general pattern of results is often reported, it is not clear to what extent this implicit difference reflects negative associations with CNM. To investigate this issue, the current study assessed 355 U.S. early emerging adults' (89 men, 265 women, one gender nonconforming) implicit associations with CNM and monogamy using the Single-Target Implicit Association Test (ST-IAT). In addition, the convergent (using explicit measures), postdictive, and concurrent validity of the CNM ST-IAT was also investigated. The results revealed that although early emerging adults demonstrated a positive implicit association with monogamy (mean D score = 0.38), a neutral implicit association emerged for CNM (mean D score = 0.00). Additionally, young women and those without previous CNM experience demonstrated more negative implicit associations with CNM as compared to men and those with previous CNM experience. Finally, implicit associations with CNM predicted willingness to allow one's partner to participate in CNM, but not one's own interest in CNM. These results support previous research suggesting that a disparity in attitudes toward CNM and monogamy exists and provides further clarification reflecting positive implicit associations with monogamy and neutral associations with CNM. These results also confirm that monogamous relationships continue to be upheld as the ideal relationship structure in the U.S. and that educators/practitioners should work to reduce negative implicit bias toward CNM in an attempt to promote relationship equity.

Heterosexual Young Adults' Interest, Attitudes, and Experiences Related to Mixed-Gender, Multi-Person Sex.

There has been little research on threesomes, a form of multi-person sex that involves sexual activity with two other people simultaneously. Therefore, we examined young adults' attitudes toward, interest in, and experiences with one form of threesome, mixed-gender threesomes (MGTs), defined as sexual activity involving three people where at least one member of each gender is present. Participants were 274 (202 women, 72 men) heterosexual young adults who completed an online survey. Overall, 13 % of participants (24 % of men and 8 % of women) reported experience and 64 % reported some interest in engaging in an MGT. However, the overall level of interest was quite low and varied according to contextual variables (i.e., what other persons were involved). Men's interest remained unaffected by third person status as long as the MGT involved familiar others (friends and acquaintances) rather than strangers, whereas women preferred familiar others only for MGTs with which they were the third person, not for those involving a romantic partner. Participants also reported fairly neutral attitudes toward MGTs. Compared to the women, the men reported significantly more positive attitudes and greater interest, and were more likely to report MGT experience. In addition, attitudes, interest, and experience were all positively associated with each other. Taken together, these results suggest that young people are not judgmental about others engaging in MGTs but are not highly motivated to do so themselves. Implications for researchers and sexual health educators are discussed.

Computer use in primary care practices in Canada.

OBJECTIVE: To examine the use of computers in primary care practices. DESIGN: The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data. SETTING: All 10 Canadian provinces. PARTICIPANTS: A total of 788 family physicians. MAIN OUTCOME MEASURES: A computer use scale measured the extent to which family physicians integrated computers into their practices, with higher scores indicating a greater integration of computer use in practice. Analyses included t tests and 2 tests comparing new and traditional models of primary care on measures of computer use and electronic health record (EHR) use, as well as descriptive statistics. RESULTS: Nearly all (97.5%) physicians reported using a computer in their practices, with moderately high computer use scale scores (mean [SD] score of 5.97 [2.96] out of 9), and many (65.7%) reported using EHRs. Physicians with practices operating under new models of primary care reported incorporating computers into their practices to a greater extent (mean [SD] score of 6.55 [2.64]) than physicians operating under traditional models did (mean [SD] score of 5.33 [3.15]; t726.60 = 5.84; P < .001; Cohen d = 0.42, 95% CI 0.808 to 1.627) and were more likely to report using EHRs (73.8% vs 56.7%; [Formula: see text]; P < .001; odds ratio = 2.15). Overall, there was a statistically significant variability in computer use across provinces. CONCLUSION: Most family physicians in Canada have incorporated computers into their practices for administrative and scholarly activities; however, EHRs have not been adopted consistently across the country. Physicians with practices operating under the new, more collaborative models of primary care use computers more comprehensively and are more likely to use EHRs than those in practices operating under traditional models of primary care.

The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study.

BACKGROUND: Canadians' health care-seeking behaviour for physical and mental health issues was examined using the international Quality and Cost of Primary Care (QUALICOPC) survey that was conducted in 2013 in Canada. METHOD: This study used the cross-sectional Patient Experiences Survey collected from 7260 patients in 759 practices across 10 Canadian provinces as part of the QUALICOPC study. A Responsive Care Scale (RCS) was constructed to reflect the degree of health care-seeking behaviour across 11 health conditions. Using several patient characteristics as independent variables, four multiple regression analyses were conducted. RESULTS: Patients' self-reports indicated that there were gender differences in health care-seeking behaviour, with women reporting they visited their primary care provider to a greater extent than did men for both physical and mental health concerns. Overall, patients were less likely to seek care for mental health concerns in comparison to physical health concerns. For both women and men, the results of the regressions indicated that age, illness prevention, trust in physicians and chronic conditions were important factors when explaining health care-seeking behaviours for mental health concerns. CONCLUSION: This study confirms the gender differences in health care-seeking behaviour advances previous research by exploring in detail the variables predicting differences in health care-seeking behaviour for men and women. The variables were better predictors of health care-seeking behaviour in response to mental health concerns than physical health concerns, likely reflecting greater variation among those seeking mental health care. This study has implications for those working to improve barriers to health care access by identifying those more likely to engage in health care-seeking behaviours and the variables predicting health care-seeking. Consequently, those who are not accessing primary care can be targeted and policies can be developed and put in place to promote their health care-seeking behavior.

Do new and traditional models of primary care differ with regard to access?: Canadian QUALICOPC study.

OBJECTIVE: To examine access to primary care in new and traditional models using 2 dimensions of the concept of patient-centred access. DESIGN: An international survey examining the quality and costs of primary health care (the QUALICOPC study) was conducted in 2013 in Canada. This study adopted a descriptive cross-sectional survey method using data from practices across Canada. Each participating practice filled out the Family Physician Survey and the Practice Survey, and patients in each participating practice were asked to complete the Patient Experiences Survey. SETTING: All 10 Canadian provinces. PARTICIPANTS: A total of 759 practices and 7172 patients. MAIN OUTCOME MEASURES: Independent t tests were conducted to examine differences between new and traditional models of care in terms of availability and accommodation, and affordability of care. RESULTS: Of the 759 practices, 407 were identified as having new models of care and 352 were identified as traditional. New models of care were distinct with respect to payment structure, opening hours, and having an interdisciplinary work force. Most participating practices were from large cities or suburban areas. There were few differences between new and traditional models of care regarding accessibility and accommodation in primary care. Patients under new models of care reported easier access to other physicians in the same practice, while patients from traditional models reported seeing their regular family physicians more frequently. There was no difference between the new and traditional models of care with regard to affordability of primary care. Patients attending clinics with new models of care reported that their physicians were more involved with them as a whole person than patients attending clinics based on traditional models did. CONCLUSION: Primary care access issues do not differ strongly between traditional and new models of care; however, patients in the new models of care believed that their physicians were more involved with them as people.

Sex differences in the ability to recognise non-verbal displays of emotion: a meta-analysis.

The present study aimed to quantify the magnitude of sex differences in humans' ability to accurately recognise non-verbal emotional displays. Studies of relevance were those that required explicit labelling of discrete emotions presented in the visual and/or auditory modality. A final set of 551 effect sizes from 215 samples was included in a multilevel meta-analysis. The results showed a small overall advantage in favour of females on emotion recognition tasks (d=0.19). However, the magnitude of that sex difference was moderated by several factors, namely specific emotion, emotion type (negative, positive), sex of the actor, sensory modality (visual, audio, audio-visual) and age of the participants. Method of presentation (computer, slides, print, etc.), type of measurement (response time, accuracy) and year of publication did not significantly contribute to variance in effect sizes. These findings are discussed in the context of social and biological explanations of sex differences in emotion recognition.

Rose Colored Glasses: An Exploration of the Relationship between Sexual Nostalgia and Sexual Satisfaction.

Sexual satisfaction contributes significantly to one's quality of life and offers a variety of mental and physical health benefits. Consequently, numerous studies have examined ways to improve sexual satisfaction. However, no research has investigated how sexual nostalgia (i.e., "the sentimental longing for or wistful reflection on past sexual memories," p. 1539) with one's current partner impacts sexual satisfaction. Thus, this program of research was designed to develop the Sexual Nostalgia Inventory, assess the relationship between sexual nostalgia and sexual satisfaction, and to examine the moderating role of romantic attachment. The results of Study One (N = 227) indicated that the content of sexual memories can be conceptualized into one factor. The results from Study Two (N = 619) revealed that sexual nostalgia was positively related to sexual satisfaction and that romantic attachment moderated these relationships. In particular, the positive association between sexual nostalgia and satisfaction was greatest for those insecurely attached (i.e., those high in anxious and avoidant attachment). These findings have important implications for researchers looking to establish the causal link between nostalgia and satisfaction and clinicians working with couples experiencing low sexual desire and/or unmet sexual needs.

Can a kiss conquer all? The predictive utility of idealized first kiss beliefs on reports of romantic love among U.S. adults.

Research indicates that idealized romantic expectations and the extent to which they are met, are important predictors of relationship outcomes (e.g., love). However, no studies have investigated the impact of idealized beliefs associated with specific behaviors (e.g., kissing) on reports of romantic love. Thus, the two studies comprising this research assessed the association between idealized beliefs related to one's first romantic kiss with their current partner, unmet first kiss expectations, and reports of romantic love. Romantic attachment was also examined as a moderator. In Study One, the First Kiss Beliefs Scale was created and the results from 208 adults revealed that increased endorsement of idealized first kiss beliefs was associated with greater romantic love (r = 0.25). Romantic attachment also moderated this relationship, such that idealized first kiss beliefs significantly predicted love for those high in attachment anxiety and low in avoidance (ß = 0.68 and ß = 0.18, respectively). In Study Two, the First Kiss Beliefs Scale was modified to assess outcomes and expectations to capture unmet expectations. The results from 234 adults indicated that idealized first kiss beliefs predicted a greater proportion of the variance in romantic love (sr2 = 0.10) than did unmet expectations (sr2 = 0.07). A three-way interaction was also detected such that, among those low in attachment anxiety, the relationship between kissing beliefs and love was positive for those high in attachment avoidance and negative for those low. These results indicate that idealized first kiss expectations with one's current romantic partner are important predictors of love (beyond whether these expectations were met), particularly for those high in attachment insecurity. Implications are discussed for practitioners and those in the primary stages of romantic relationships.

Gender differences in associations of sexual and romantic stimuli: do young men really prefer sex over romance?

Theory and research emphasize differences in men's and women's sexual and romantic attitudes, concluding that men have stronger preferences for sexual than romantic stimuli as compared to women. However, most of the research on gender differences have relied on self-reports, which are plagued by problems of social desirability bias. The current study assessed young men's and women's implicit attitudes toward sexual and romantic stimuli to test whether, in fact, men have a stronger preference for sexual over romantic stimuli compared to women. We also assessed associations between implicit and explicit attitudes, as well as sex role ideology and personality. College students (68 men and 114 women) completed an Implicit Association Test (IAT) that assessed strengths of associations of sexual and romantic stimuli to both pleasant and unpleasant conditions. Results revealed that both men and women more strongly associated romantic images to the pleasant condition than they associated the sexual images to the pleasant condition. However, as predicted, women had a stronger preference toward romantic versus sexual stimuli compared to men. Our study challenges a common assumption that men prefer sexual over romantic stimuli. The findings indicate that measures of implicit attitudes may tap preferences that are not apparent in studies relying on self-reported (explicit) attitudes.

The Development of a Measure Assessing U.S. Adults' Motives for Marriage.

Despite the existing literature assessing various aspects of marriage, there is a lack of understanding of adults' motives for pursuing marriage. Thus, this research advanced the literature by assessing adults' motives for marriage via four novel studies in which the Motives for Marriage Scale (MMS) was developed, refined, and validated. In study one, semi-structured focus groups were conducted to capture the range of motives for marriage. In study two, the factor structure of the MMS was assessed. The factor structure was then validated and the psychometric properties were established in study three. Finally, the temporal consistency of the scale was established in study four. The results confirmed that adults' marital motives are complex and that they are best conceptualized using Social Determination Theory (i.e., intrinsic, extrinsic, and instrumental motives). Investigation of the psychometric properties demonstrated the MMS to be reliable and valid. Implications for investigators and practitioners are discussed.

Examining Variations in Participation and Outcomes of Consensual and Nonconsensual Extradyadic Behavior among Ashley Madison Users.

Despite the abundance of studies investigating individual differences associated with extradyadic behavior (EB), nearly all have adopted retrospective measures in which the data is likely plagued by recall biases. In addition, few studies have explored individual differences or outcomes associated with EB between those with consenting and nonconsenting primary partners. Thus, the current study investigated the extent to which Ashley Madison users participated in a wide range of EBs, whether age, gender, and sexual identity predicted participation, and the extent to which outcomes were impacted by partner consent. The results from 1460 adults (962 men, 498 women) revealed that users reported engaging in three categories of behaviors: sexual/explicit, technology/online, and emotional/affectionate behaviors and that women and those older in age reported participating in EBs more frequently than men and those younger in age. Finally, 16.9% of the sample had a primary partner that consented to their Ashley Madison use and those with consenting partners reported greater perceived improvement in their primary relationship than did those with nonconsenting partners. Our findings highlight the importance of assessing the multitude of behaviors that Ashley Madison users participate in and whether consent was obtained. Implications for educators and practitioners are discussed.

Sex on the Screen: A Content Analysis of Free Internet Pornography Depicting Mixed-Sex Threesomes from 2012-2020.

Viewing online pornography is common among US adults, with mixed-sex threesome (MST) videos being one of the top 10 most popular categories of pornography for both men and women. The current content analysis applied sexual script theory to understand the themes present in these mixed-sex threesome videos. Independent coders viewed a total of 50 videos (25 MMF and 25 FFM) at each timepoint (2012, 2015, 2020) and coded for different sexual behaviors and themes in each video. By examining both same-sex (female-female, male-male) and other-sex (female-male) behaviors, as well as themes of aggression and sexual initiation in different videos and across three timepoints, it was determined that other-sex behaviors are more common in MST videos than same-sex behaviors. Same-sex behaviors between two female actors were more common than same-sex behaviors between two male actors. Aggression was a common theme in videos, with male actors being more aggressive on average than female actors. Most of these trends did not change across 8 years, suggesting that the impacts of traditional sexual scripts are pervasive in pornography, even in current online content. Important implications for both researchers and clinical professionals are discussed.

The Development and Psychometric Validation of a Comprehensive Measure Assessing Fear of Incompetence among Adults Who Have a Family Member with Dementia.

Because the interpersonal skills of individuals with dementia often decline, family members may question their own ability to interact meaningfully. These family members may experience fear of incompetence (i.e., fear of being unable to relate in a meaningful way or take care of a close family member with dementia). Thus, the goal of this research was to develop, refine, and psychometrically validate a scale (Fear of Incompetence-Dementia Scale; FOI-D) assessing fear of incompetence in the context of relationships with a close family member diagnosed with dementia. Three online studies were conducted to accomplish the primary objective. In Study One, the factor structure of the FOI-D was assessed by conducting an exploratory factor analysis using data from 710 adults who indicated having a close living family member who had been diagnosed with dementia. In Study Two, the factor structure was validated via a confirmatory factor analysis and the psychometric properties were established using data from 636 adults who had a family member with dementia. Finally, Study Three determined the temporal consistency of the scale by retesting 58 participants from Study Two. The results from Study One indicated that the FOI-D Scale accounted for 51.75% of the variance and was comprised of three subscales: the Interaction Concerns subscale, the Caregiving Concerns subscale, and the Knowledge Concerns subscale. In Study Two, the three-factor structure was supported, resulting in a 58-item scale. Investigation of the psychometric properties demonstrated the FOI-D to be reliable and valid. In Study Three, the FOI-D Scale demonstrated excellent temporal consistency. This research provides future investigators, educators, and practitioners with an adaptable comprehensive tool assessing fear of incompetence in a variety of settings.