Evaluation and acceptance of mobile-electrocardiogram use in implantable cardioverter defibrillator patients - Can I see my ECG?

BACKGROUND: Medical technologies for consumers aim to help prevent, manage, and even forecast cardiovascular events, but their emotional impact is not fully known. The value of mobile-electrocardiogram (mECG) technology to an existing group of cardiac patients is unknown. The purpose of this study was to examine the impact of readily available mECG capability for a sample of implantable cardioverter defibrillator (ICD) patients. METHODS: Patients with ICDs (N = 51) were recruited and consented in a large academic cardiology clinic. Participants were given a mECG device and asked to take a 30-ss reading at least once per day for 30 days. Technology satisfaction, cardiac anxiety, shock anxiety, and ICD device acceptance were measured pre- and post-mECG usage. RESULTS: mECG technology was regularly used (M = 36.6 readings completed per month) and positively appraised by ICD patients (mean of 4.4 out of possible 5). Self-reported symptoms of general cardiac anxiety were not significantly affected by the utilization of mECG technology. ICD specific measures were mixed with increased overall ICD device acceptance but also increased shock anxiety. CONCLUSIONS: ICD patients positively viewed and used mECG technology regularly as prescribed. However, the overall psychological impact of mECG was mixed and suggests that ICD patients may have idiosyncratic adjustments to the increased access of cardiac device data.

College students' stigmatization of people with mental illness: familiarity, implicit person theory, and attribution.

BACKGROUND: Stigma associated with mental illness (MI) results in underutilization of mental health care. We must understand factors contributing to stigma to shape anti-stigma campaigns. AIMS: To investigate the factors influencing stigma in university students. METHOD: Undergraduate psychology students completed measures on causal attribution, stigma, social distance, implicit person theory (IPT), and familiarity. RESULTS: The hypothesis was partially supported; people who felt personality traits were unchangeable (i.e. entity IPT) were more likely to stigmatize individuals with mental disorders and desired more social distance from them. Familiarity with people with a MI individually predicted less desire for social distance, yet the redundancy of the predictors made the effect of familiarity on stigma fall just short of statistical significance. Judgments of biogenetic causal attribution were related to higher stigma levels, but not so when familiarity and IPT were taken into account. CONCLUSIONS: Educational campaigns may be effective by focusing on aspects of MI highlighting similarity with non-diagnosed people, and that people with MI can recover.

Racial Differences in Adolescents' Answering Questions About Suicide.

The present purpose was to examine racial differences in response rate and serious behavioral suicide risk based on the national Youth Risk Behavior Surveillance Survey (YRBS). Data from 15,245 adolescents (YRBS, 2011) were included. Survey items pertaining to making suicidal plans and attempting suicide were included. Significant differences in responding and content emerged, especially with regard to suicide attempts. Racial minority adolescents are at elevated risk for serious suicidal behaviors and are more likely to omit items pertaining to suicide attempts. African American adolescents rarely reported having attempted suicide, but they also frequently failed to respond to that question.

SPSS and SAS programs for comparing Pearson correlations and OLS regression coefficients.

Several procedures that use summary data to test hypotheses about Pearson correlations and ordinary least squares regression coefficients have been described in various books and articles. To our knowledge, however, no single resource describes all of the most common tests. Furthermore, many of these tests have not yet been implemented in popular statistical software packages such as SPSS and SAS. In this article, we describe all of the most common tests and provide SPSS and SAS programs to perform them. When they are applicable, our code also computes 100 × (1 - α)% confidence intervals corresponding to the tests. For testing hypotheses about independent regression coefficients, we demonstrate one method that uses summary data and another that uses raw data (i.e., Potthoff analysis). When the raw data are available, the latter method is preferred, because use of summary data entails some loss of precision due to rounding.

The role of self-compassion in physical and psychological well-being.

The relation of self-compassion to physical and psychological well-being was investigated among 182 college students. The self-compassion scale was delineated into three composites, following the proposition by Neff that self-compassion consists of three main components: self-judgment versus self-kindness (SJ-SK), a sense of isolation versus common humanity (I-CH), and over-identification versus mindfulness (OI-M). Findings support the association between self-compassion and psychological and physical well-being, but the composites demonstrate different influences. SJ-SK and I-CH were predictive of both depressive symptomatology and physical well-being, and SJ-SK and OI-M were predictive of managing life stressors. The results of this study support and expand prior research on self-compassion.

Health Security Perceptions: Initial Psychometric Analysis of the Construct of Health Security in Chronic Illness Among Patients With a Cardiac Device.

Scale measuring the construct of "health security in chronic illness" (HSCI) was piloted in Canadian cardiac device patients (N = 176) enrolled in a remote-monitoring study at 2 timepoints. Analysis revealed a 2-factor solution, labeled as "support" and "certainty". Patients reported receiving less support over time, but consistent health certainty. Patients with implantable cardioverter defibrillators felt less secure over time and reported lower levels of health security in chronic illness than pacemaker patients.

Une échelle mesurant le concept de la « sécurité en matière de santé en présence d'une maladie chronique ¼ a fait l'objet d'un projet pilote auprès de patients canadiens porteurs de dispositifs cardiaques (N = 176) inscrits dans une étude de télésurveillance comportant deux évaluations. L'analyse a révélé une solution à deux facteurs, soit le soutien et la certitude. Les patients ont déclaré qu'ils recevaient moins de soutien au fil du temps, mais que la certitude quant à leur santé était constante. Les porteurs d'un défibrillateur cardioverteur implantable se sentaient moins en sécurité au fil du temps et signalaient de plus bas niveaux de sécurité en matière de santé, relativement à leur maladie chronique, que les porteurs d'un stimulateur cardiaque.

Personality correlates of adherence with continuous positive airway pressure (CPAP).

INTRODUCTION: Adherence with continuous positive airway pressure (CPAP) for obstructive sleep apnea (OSA) has been problematic. Understanding the factors associated with nonadherence may assist with psychosocial interventions. OBJECTIVE: The objective of this study was to examine the relationship between adherence and three measures of personality and coping strategies. METHODS: Ratings on the behavioral inhibition system/behavioral activation system (BIS/BAS) scales, the ways of coping inventory, and a broad personality measure (mini-IPIP) were analyzed with a binary logistic regression among 63 subjects, adult men (31) and women (32), diagnosed with OSA. Data from the CPAP device was obtained following initial 30 days at minimum, with adherence defined as >4 h/night on 70% of nights. RESULTS: Elevated BIS was the strongest predictor of nonadherence (r = -.452, p < .01), followed by neuroticism. The regression correctly classified 73% of participants as adherent or nonadherent. CONCLUSION: Nonadherence is associated with elevated BIS scores and neuroticism, which indicates that personality factors play a role in determining adherence to CPAP. Although more research is needed to draw firm conclusions, the differences noted in BIS may also point toward differences in neurophysiological function. The BIS scale may be a useful tool for predicting nonadherence and assist with the development of intervention strategies that will increase adherence.

Workaholism and work-life imbalance: does cultural origin influence the relationship?

In recent years, workaholism has become prevalent throughout organizations and has captured the attention of organizational leaders as well as the academic and scientific communities. Most research in this area has focused on the negative consequences of workaholism, specifically work-life imbalance. One area of research that has largely been ignored is the potential influence of demographic variables on the relationship between workaholism and work-life imbalance. Therefore, the current study focused on how cultural origin might influence the intensity of this relationship. Based on relative deprivation theory and previous empirical work, it was expected that cultural origin would moderate the relationship between workaholism and work-life imbalance. Specifically, it was predicted that Caucasian participants would score higher on levels of workaholism than Black participants, and that the relationship between workaholism and work-life imbalance would be stronger for Caucasians than for Blacks. The results revealed that high levels of workaholism were significantly correlated with high levels of work-life imbalance. However, results also indicated that cultural origin did not moderate the relationship between workaholism and work-life imbalance, and there was no significant mean difference between Caucasian and Black participants on our measure of workaholism. These findings are important in that it is essential for employers to be aware of workaholic tendencies so they can better handle the negative consequences that result for the organization, and to also help promote the well-being of their employees. En los últimos años la adicción al trabajo se ha vuelto muy popular en las organizaciones y ha capturado la atención tanto de líderes organizacionales, así como de las comunidades científicas y académicas. La mayoría de investigaciones en esta área se han focalizado en las consequencias negativas de la adicción al trabajo (workoholismo), específicamente en el desequilibrio entre trabajo-vida. Una área de investigación que ha sido ignorada por mucho tiempo es la influencia potencial de las variables demográficas sobre la relación entre adicción al trabajo y el desequilibrio trabajo-vida. Por este motivo es que el presente estudio se focalizó en como el origen cultural puede influenciar la intensidad de esta relación. Tomando como base la teoría de la deprivación relativa y estudios empíricos previos, se esperó que el origen cultural moderaría la relación entre adicción al trabajo y desequilibrio trabajo-vida. Específicamente se pudo predecir que los participantes caucásicos mostraron más elevados puntajes en los niveles de adicción al trabajo que los participantes negros, y que la relación entre adicción al trabajo y desequilibrio trabajo-vida era más intensa entre los caucásicos que entre los negros. Los resultados revelaron que elevados niveles de adicción al trabajo correlacionaron significativamente con altos niveles de desequilibrio trabajo-vida. Sin embargo los resultados también revelaron que el origen cultural no moderaba la relación entre adicción al trabajo y desequilibrio trabajo-vida, y que además no había una diferencia significativa de medias entre los participantes caucásicos y negros respecto de nuestras mediciones de adicción al trabajo. Estos resultados son importantes en la medida en que es esencial para los empleadores el ser conscientes respecto de las tendencias de adicción al trabajo, lo que les permitirá manejar con mayor efectividad las consequencias negativas para la empresa resultantes de estas tendencias, y por otro lado apoyar a sus empleados en la promoción de su bienestar. Au cours des dernières années, le travaillolisme (workaholism) a pris de l'ampleur dans les organisations et a capté l'attention à la fois des dirigeants d'organisations et des communautés académique et scientifique. La majorité de la recherche dans ce domaine fut orientée sur les conséquences négatives du travaillolisme et, plus spécifiquement, sur le conflit travail-vie. Un champ de recherche qui a été largement ignoré est l'influence potentielle des variables démographiques sur la relation entre le travaillolisme et le conflit travail-vie. La présente étude visait à comprendre comment l'origine culturelle peut influencer l'intensité de cette relation. Se basant sur la théorie de la privation relative et sur les travaux empiriques antérieurs, il était attendu que l'origine culturelle allait jouer un rôle modérateur dans la relation entre le travaillolisme et le conflit travail-vie. Plus spécifiquement, il était prédit que les participants caucasiens allaient obtenir des scores plus élevés de travaillolisme comparativement aux participants noirs, et que la relation entre le travaillolisme et le conflit travail-vie allait être plus forte pour les caucasiens que pour les noirs. Les résultats ont révélé que des niveaux élevés de travaillolisme étaient significativement corrélés avec des niveaux élevés de conflit travail-vie. Cependant, les résultats ont aussi indiqué que l'origine culturelle ne modère pas la relation entre le travaillolisme et le conflit travail-vie. De plus, il n'y avait pas de différence significative entre les participants caucasiens et les participants noirs sur notre mesure de travaillolisme. Ces résultats sont importants puisqu'il est essentiel pour les employeurs d'être à l'affût des tendances travaillolistes pour qu'ils puissent mieux en gérer les conséquences négatives pour l'organisation, ainsi que pour aider à promouvoir le bien-être de leurs employés. diferenciaban en algunos aspectos.

Enrichment, stress, and growth from parenting an individual with an autism spectrum disorder.

BACKGROUND: Past researchers have focused primarily on the associated negative impact of caring for a child with special needs. In this study, caregivers report the enrichment and stress of caring for a child with an autism spectrum disorder. METHOD: Eighty caregivers completed the Social Communication Questionnaire (SCQ), Effects of the Situation Questionnaire (ESQ), and Posttraumatic Growth Inventory (PTGI). Enrichment and stress scores were compared to symptom severity data and posttraumatic growth scores. RESULTS: Consistent with prior research, caregivers reported greater levels of stress than enrichment. On just over half of the stress/enrichment variables, parental ratings of stress and enrichment were negatively correlated. Scores of total stress and enrichment were not correlated to the severity of the individual's symptoms or caregivers' growth scores. CONCLUSIONS: These findings suggest that although stress is a major concern for caregivers, enrichment and growth may also occur in varying degrees.

Exploring the relationship between frontal asymmetry and emotional dampening.

Cardiovascular emotional dampening is the term used to describe the inverse relationship between resting blood pressure and emotional responsivity which extends from normotensive to hypertensive ranges. Little is known about its underlying physiological mechanisms, but it is thought to involve some disruption in emotion processing. One area that has yet to be explored in the literature is the relationship between emotional dampening and frontal asymmetry, a psychophysiological indicator for motivational direction and emotional valence bias. The present study explored that relationship using data from a sample of 48 healthy college students. Measures of baseline resting blood pressure and frontal cortical activity were recorded, after which participants completed a series of emotion-related tasks. Results revealed a significant relationship between resting systolic blood pressure and left frontal activity. Likewise, left frontal activity was associated with neutral appraisal of emotionally valenced stimuli within the tasks. The findings from the present study yield support for a link between emotional dampening and left frontal activity. Implications are discussed.

eMindLog: Self-Measurement of Anxiety and Depression Using Mobile Technology.

BACKGROUND: Quantifying anxiety and depressive experiences permits individuals to calibrate where they are and monitor intervention-associated changes. eMindLog is a novel self-report measure for anxiety and depression that is grounded in psychology with an organizing structure based on neuroscience. OBJECTIVE: Our aim was to explore the psychometric properties of eMindLog in a nonclinical sample of subjects. METHODS: In a cross-sectional study of eMindLog, a convenience sample of 198 adults provided informed consent and completed eMindLog and the Hospital Anxiety and Depression Scale (HADS) as a reference. Brain systems (eg, negative and positive valence systems, cognitive systems) and their functional states that drive behavior are measured daily as emotions, thoughts, and behaviors. Associated symptoms, quality of life, and functioning are assessed weekly. eMindLog offers ease of use and expediency, using mobile technology across multiple platforms, with dashboard reporting of scores. It enhances precision by providing distinct, nonoverlapping description of terms, and accuracy through guidance for scoring severity. RESULTS: eMindLog daily total score had a Cronbach alpha of .94. Pearson correlation coefficient for eMindLog indexes for anxiety and sadness/anhedonia were r=.66 (P<.001) and r=.62 (P<.001) contrasted with the HADS anxiety and depression subscales respectively. Of 195 subjects, 23 (11.8%) had cross-sectional symptoms above the threshold for Generalized Anxiety Disorder and 29 (29/195, 14.9%) for Major Depressive Disorder. Factor analysis supported the theoretically derived index derivatives for anxiety, anger, sadness, and anhedonia. CONCLUSIONS: eMindLog is a novel self-measurement tool to measure anxiety and depression, demonstrating excellent reliability and strong validity in a nonclinical population. Further studies in clinical populations are necessary for fuller validation of its psychometric properties. Self-measurement of anxiety and depressive symptoms with precision and accuracy has several potential benefits, including case detection, tracking change over time, efficacy assessment of interventions, and exploration of potential biomarkers.

It's not what you expect: feedback negativity is independent of reward expectation and affective responsivity in a non-probabilistic task.

ERP studies commonly utilize gambling-based reinforcement tasks to elicit feedback negativity (FN) responses. This study used a pattern learning task in order to limit gambling-related fallacious reasoning and possible affective responses to gambling, while investigating relationships between the FN components between high and low reward expectation conditions. Eighteen undergraduates completed measures of reinforcement sensitivity, trait and state affect, and psychophysiological recording. The pattern learning task elicited a FN component for both high and low win expectancy conditions, which was found to be independent of reward expectation and showed little relationship with task and personality variables. We also observed a P3 component, which showed sensitivity to outcome expectancy variation and relationships to measures of anxiety, appetitive motivation, and cortical asymmetry, although these varied by electrode location and expectancy condition. Findings suggest that the FN reflected a binary reward-related signal, with little relationship to reward expectation found in previous studies, in the absence of positive affective responses.

Contraception and reproductive counseling in women with peripartum cardiomyopathy.

OBJECTIVES: Pregnancies following a diagnosis of peripartum cardiomyopathy (PPCM) are associated with increased risk for maternal morbidity and mortality. Yet patterns of contraceptive use and reproductive counseling have received little attention. This nationwide registry-based study sought to evaluate patterns and clinical characteristics associated with contraceptive use, and examine the prevalence of contraceptive counseling in women with PPCM. METHODS: From December 2015 to June 2016, 177 PPCM patients (mean age of 34.8±5.7years, median time since diagnosis of 3.0±4.3years) completed questionnaires about contraceptive use and counseling at registry enrollment. T Tests, chi-square and logistic regression were used to compare demographic and clinical characteristics among women who reported contraceptive use vs. nonuse. RESULTS: Tubal ligation (24.3%), condoms (22.0%) and intrauterine devices (IUDs; 16.4%) were the most common forms of contraception. Among sexually active women, 28.9% reported contraceptive nonuse. Contraceptive users had a lower body mass index higher education, and were less likely to be in a dating relationship, have hypertension, wear an external cardioverter-defibrillator, and use antihypertensive medications compared with nonusers (all p<0.05). Two-thirds of women received counseling about risks of subsequent pregnancies and contraceptive strategies. CONCLUSIONS: This preliminary study indicates that 1 in 4 PPCM patients are sexually active and are not using contraception to prevent PPCM reoccurrence. Although a majority of women did receive reproductive counseling, as many as 25% of patients reported no discussion of contraceptive strategies to prevent unintended pregnancy and heart failure relapse.

Depression and health behaviors in women with Peripartum Cardiomyopathy.

BACKGROUND: Depression and health behavior engagement are a critical issue for recovery and secondary prevention in heart failure patients. No prior studies have examined these important clinical outcomes in young women diagnosed with Peripartum Cardiomyopathy (PPCM). We sought to characterize the prevalence of depression and health behaviors in PPCM patients and examine whether depression is associated with reduced engagement in health behaviors. METHODS: A nation-wide, cohort of 177 PPCM patients (mean age of 34.8 ± 5.7 years; median time since diagnosis of 3.0 ± 4.3 years) from a web-based quality of life registry completed questionnaires about depression (Patient Health Questionnaire; a cutoff score ≥10 was used for depression screening) and health behaviors. T-tests, chi-square and linear regression were used to compare clinical characteristics and health behaviors among depressed and non-depressed women. RESULTS: The prevalence of clinical depression at enrollment was 32.3% and was associated with use of antihypertensive medications, disability insurance status, higher BMI, history of arrhythmia and current or past use of psychotropic medication. Health behavior engagement for diet, physical activity, and tobacco cessation were low in the overall sample and depressed PPCM patients were significantly less likely to attend medical appointments than non-depressed women. CONCLUSIONS: Nearly 1 in 3 PPCM survivors reported symptoms of clinical depression which was associated with worse attendance at medical follow-up visits. Further research is needed to develop risk stratification models and patient-centered interventions to improve clinical outcomes for PPCM survivors.

Comparison of rural and urban residents' implicit and explicit attitudes related to seeking medical care.

CONTEXT: The decision whether or not to consult a physician draws from a variety of attitudes within an individual's health schema. While rural Americans are in greater need of health care, many of them have fewer external resources than urbanites available to them. PURPOSE: The objective of this study was to elicit implicit and explicit attitudes related to seeking medical treatment for a condition described as fairly serious. Participants were asked to rate how often they comply with treatment regimens and practice good health habits. METHODS: The sample of rural (N = 586) and urban (N = 433) North Carolina residents was derived based on random-digit dialing. Multiple regression analyses were performed to investigate how attitudes associated with perceived compliance and health behaviors. FINDINGS: While rural and urban residents offered very similar responses, the associations between attitudes and behaviors were different. One healthy and 2 unhealthy schema patterns emerged. First, fear of hospitals was associated with effective compliance for rural residents and good health habits for urbanites. Second, affordability concerns were ascribed to rural community residents but seemed to reflect personally relevant implicit attitudes since they were associated with poor health adherence and habits for rural residents. Third, mistrust of doctors predicted low adherence for both groups and was also associated with poorer health habits for urbanites. With inconsistencies among implicit and explicit attitudes and behaviors, some residents seemed to be ambivalent about seeking health care.

Effects of physical attractiveness on evaluations of a male employee's allegation of sexual harassment by his female employer.

College students (N = 324) served as mock jurors in a simulated civil case in which a male plaintiff accused a female defendant of sexual harassment. The authors experimentally manipulated the physical attractiveness of the litigants. The authors asked mock jurors to decide whether the defendant was guilty and to rate their certainty of belief in the defendant's guilt (or lack of guilt). Jurors were more certain of the guilt of the defendant when the plaintiff was attractive than when he was unattractive. Plaintiff attractiveness significantly affected female jurors' individual recommended verdicts when the defendant was unattractive but not when she was attractive. With male jurors, plaintiff attractiveness significantly affected their verdicts when the defendant was attractive but not when she was unattractive. Female jurors were more likely than male jurors to conclude that sexual harassment had taken place but only when the litigants were different in attractiveness.

Racial bias in decisions made by mock jurors evaluating a case of sexual harassment.

White (N = 161) and Black (N = 152) college students served as mock jurors in a simulated civil case in which a female plaintiff accused a male defendant of sexual harassment. The authors experimentally manipulated the race (Black or White) of the litigants and asked the mock jurors to decide whether the defendant was guilty; to rate the certainty of their belief in the defendant's guilt; and, when they judged the defendant guilty, to recommend an award to the plaintiff. Mock jurors of both races tended to favor litigants of their own race and their own gender. Racial bias was highest among White male jurors and lowest among White female jurors.

Former Latchkey Children: Personality and Academic Correlates.

The purpose of this study was to examine the prevalence and correlates (demographic, personality, and academic) of former latchkey status (children unsupervised by an adult after school during their elementary or middle school years) in a college student sample (N = 188). A clear operational definition of latchkey status was provided. Students were surveyed and administered a personality questionnaire, and their academic aptitude test scores were verified through university records. Twenty-five percent of the male and 14% of the female participants were identified as former latchkey children, resulting in an 18% latchkey prevalence rate. The mean age of onset of latchkey status was 8.7 years for the male and 10.0 years for the female subjects. Having been a latchkey child was positively associated with being male and Caucasian, coming from a one-parent family, and having had a mother who worked outside the home. Multivariate analyses of the personality and academic measures revealed no significant between-group differences.

Healthy high-hostiles evidence low-alpha power (7.5-9.5Hz) changes during negative affective learning.

The present experiment was designed to better understand the impact of positive and negative emotional processing among low- and high-hostile individuals. Based on previous research which found increased sympathovagal balance among low-hostiles to the negative version of the Affective Auditory Verbal Learning Test (AAVL), it was hypothesized that low-hostiles would experience increased cortical arousal to this stimulus whereas their high-hostile counterparts would not. As expected, low-hostiles experienced significantly reduced low-alpha power (7.5-9.5Hz) relative to high-hostiles during the presentation of the negative AAVL. In a replication of prior research, significant primacy and recency effects were noted for the negative and positive word lists, respectively. Results are discussed in terms of cerebral activation theory and the potential impact of emotional processing among high-hostile individuals and their likelihood to develop coronary heart disease.

Grip-strength, fatigue, and motor perseveration in anxious men without depression.

OBJECTIVE: To investigate the influence of anxiety without depression on functional motor asymmetry in adult men. Thus, left-and right-hand grip strength, fatigue across trials, and motor perseveration was examined among 60 right-handed men, half of whom had been classified as anxious without depression (HI, n = 30) and the other half as nonanxious without depression (LO, n = 30). BACKGROUND: There is substantial empirical support for the notion that individuals with negative affect experience relative right anterior activity. Moreover, previous studies using other groups of interest (e.g., depression and hostility) have found evidence of functional motor asymmetry that is supportive of relative right anterior activation during negative affect. Less is known about functional motor asymmetry among individuals that report anxiety without depression. METHOD: To obtain indices of perseveration, strength, and fatigue, HI and LO anxious subjects were asked to successively squeeze a hand dynamometer. Dependent measures (in kg) were derived from performance with the left and right hands across trials. RESULTS: In contrast to LO anxious subjects, HI anxious subjects did not demonstrate right-hand superiority for grip-strength. Moreover, significant positive correlations existed between grip strength and trait anxiety scores for LO anxious subjects, but not for HI anxious subjects. CONCLUSIONS: The data are partially supportive of differences in functional motor asymmetry between HI and LO anxious individuals. The findings are interpreted as supportive of relative right anterior activity (and possibly decreased left anterior activity) among individuals that report elevated levels of anxiety. Implications for relative right-hemisphere activity and decreased left anterior activity are discussed, and alternative explanations are introduced.