Developing and user testing new pharmacy label formats-A study to inform labelling standards.

BACKGROUND: Dispensed prescription medicine labels (prescription labels) are important information sources supporting safe and appropriate medicines use. OBJECTIVE: To develop and user test patient-centred prescription label formats. METHODS: Five stages: developing 12 labels for four fictitious medicines of varying dosage forms; diagnostic user testing of labels (Round 1) with 40 consumers (each testing three labels); iterative label revision, and development of Round 2 labels (n = 7); user testing of labels (Round 2) with 20 consumers (each testing four labels); labelling recommendations. Evaluated labels stated the active ingredient and brand name, using various design features (eg upper case and bold). Dosing was expressed differently across labels: frequency of doses/day, approximate times of day (eg morning), explicit times (eg 7 to 9 AM), and/or explicit dosing interval. Participants' ability to find and understand medicines information and plan a dosing schedule were assessed. RESULTS: Participants demonstrated satisfactory ability to find and understand the dosage for all label formats. Excluding active ingredient and dosing schedule, 14/19 labels (8/12 in Round 1; 6/7 in Round 2) met industry standard on performance. Participants' ability to correctly identify the active ingredient varied, with clear medicine name sign-posting enabling all participants evaluating these labels to find and understand the active ingredient. When planning a dosing schedule, doses were correctly spaced if the label stated a dosing interval, or frequency of doses/day. Two-thirds planned appropriate dosing schedules using a dosing table. CONCLUSIONS: Effective prescription label formatting and sign-posting of active ingredient improved communication of information on labels, potentially supporting safe medicines use. PATIENT AND PUBLIC INVOLVEMENT: Consumers actively contributed to the development of dispensed prescription medicine labels. Feedback from consumers following the first round was incorporated in revisions of the labels for the next round. Patient and public involvement in this study was critical to the development of readable and understandable dispensed prescription medicine labels.

Self-worth and bonding emotions are related to well-being in health-care providers: a cross-sectional study.

BACKGROUND: Interacting with patients can elicit a myriad of emotions in health-care providers. This may result in satisfaction or put providers at risk for stress-related conditions such as burnout. The present study attempted to identify emotions that promote provider well-being. Following eudaimonic models of well-being, we tested whether certain types of emotions that reflect fulfilment of basic needs (self-worth, bonding with patients) rather than positive emotions in general (as suggested by hedonic models) are linked to well-being. Specifically, we hypothesized that well-being is associated with positive emotions directed at the self, which reflect self-worth, and positive as well as negative emotions (e.g., worry) directed at the patient, which reflect bonding. However, we expected positive emotions directed at an object/situation (e.g., curiosity for a treatment) to be unrelated to well-being, because they do not reflect fulfilment of basic needs. METHODS: Fifty eight physicians, nurses, and psychotherapists participated in the study. First, in qualitative interviews, they reported their emotions directed at the self, the patient, or an object/situation during distressing interactions with patients. These emotions were categorised into positive emotions directed towards the self, the patient, and an object/situation, and negative emotions directed towards the patient that reflect bonding. Second, providers completed questionnaires to assess their hedonic and eudaimonic well-being. The well-being scores of providers who did and did not experience these emotions were compared. RESULTS: Providers who experienced positive emotions directed towards the self or the patient had higher well-being than those who did not. Moreover, for the first time, we found evidence for higher well-being in providers reporting negative patient-directed emotions during distressing interactions. There was no difference between providers who did and did not experience positive object/situation-directed emotions. CONCLUSIONS: These findings may point towards the importance of "eudaimonic" emotions rather than just positive emotions in interactions with patients. Emotions such as contentment with oneself, joy for the patient's improvement, and, notably, grief or worry for the patient may build a sense of self-worth and strengthen bonding with the patient. This may explain their association with provider well-being.

Intragroup Emotion Convergence: Beyond Contagion and Social Appraisal.

Mimicry-based emotion contagion and social appraisal currently provide the most popular explanations for interpersonal emotional convergence. However, neither process fully accounts for intragroup effects involving dynamic calibration of people's orientations during communal activities. When group members are engaged in shared tasks, they simultaneously attend to the same unfolding events and arrive at mutually entrained movement patterns that facilitate emotional coordination. Entrainment may be further cultivated by interaction rituals involving rhythmic music that sets the pace for collective singing, dancing, or marching. These rituals also provide an emotionally meaningful focus for group activities and sometimes specifically encourage the experience of intense embodied states. Intragroup emotion convergence thus depends on interlocking processes of reciprocated and context-attuned orientational calibration and group-based social appraisal.

Interpersonal effects of strategic and spontaneous guilt communication in trust games.

A social partner's emotions communicate important information about their motives and intentions. However, people may discount emotional information that they believe their partner has regulated with the strategic intention of exerting social influence. Across two studies, we investigated interpersonal effects of communicated guilt and perceived strategic regulation in trust games. Results showed that communicated guilt (but not interest) mitigated negative effects of trust violations on interpersonal judgements and behaviour. Further, perceived strategic regulation reduced guilt's positive effects. These findings suggest that people take emotion-regulation motives into account when responding to emotion communication.

Bilingual comparison of Mandarin and English cognitive bias tasks.

Most research into cognitive biases has used Western samples, despite potential East-West socio-cultural differences. One reason is the lack of appropriate measures for non-Westerners. This study is about cross-linguistic equivalence which needs to be established before assessing cross-cultural differences in future research. We developed parallel Mandarin and English measures of interpretation bias and attention bias using back-translation and decentering procedures. We assessed task equivalence by administering both sets of measures to 47 bilingual Mandarin-English speakers. Interpretation bias measurement was similar and reliable across language versions, confirming suitability of the Mandarin versions for future cross-cultural research. By contrast, scores on attention bias tasks did not intercorrelate reliably, suggesting that nonverbal stimuli such as pictures or facial expressions of emotion might present better prospects for cross-cultural comparison. The development of the first set of equivalent measures of interpretation bias in an Eastern language paves the way for future research investigating East-West differences in biased cognition.

Negative expressions are shared more on Twitter for public figures than for ordinary users.

Social media users tend to produce content that contains more positive than negative emotional language. However, negative emotional language is more likely to be shared. To understand why, research has thus far focused on psychological processes associated with tweets' content. In the current study, we investigate if the content producer influences the extent to which their negative content is shared. More specifically, we focus on a group of users that are central to the diffusion of content on social media-public figures. We found that an increase in negativity was associated with a stronger increase in sharing for public figures compared to ordinary users. This effect was explained by two user characteristics, the number of followers and thus the strength of ties and the proportion of political tweets. The results shed light on whose negativity is most viral, allowing future research to develop interventions aimed at mitigating overexposure to negative content.

Facial Regulation During Dyadic Interaction: Interpersonal Effects on Cooperation.

This study investigated interpersonal effects of regulating naturalistic facial signals on cooperation during an iterative Prisoner's Dilemma (IPD) game. Fifty pairs of participants played ten IPD rounds across a video link then reported on their own and their partner's expressed emotion and facial regulation in a video-cued recall (VCR) procedure. iMotions software allowed us to auto-code actors' and partners' facial activity following the outcome of each round. We used two-level mixed effects logistic regression to assess over-time actor and partner effects of auto-coded facial activity, self-reported facial regulation, and perceptions of the partner's facial regulation on the actor's subsequent cooperation. Actors were significantly less likely to cooperate when their partners had defected on the previous round. None of the lagged scores based on auto-coded facial activity were significant predictors of cooperation. However, VCR variables representing partner's positive regulation of expressions and actor's perception of partner's positive regulation both significantly increased the probability of subsequent actor cooperation after controlling for prior defection. These results offer preliminary evidence about interpersonal effects of facial regulation in interactive contexts and illustrate how dynamic dyadic emotional processes can be systematically investigated in controlled settings. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-023-00208-y.

Worry spreads: interpersonal transfer of problem-related anxiety.

This paper distinguishes processes potentially contributing to interpersonal anxiety transfer, including object-directed social appraisal, empathic worry, and anxiety contagion, and reviews evidence for their operation. We argue that these anxiety-transfer processes may be exploited strategically when attempting to regulate relationship partners' emotion. More generally, anxiety may serve as either a warning signal to other people about threat (alerting function) or an appeal for emotional support or practical help (comfort-seeking function). Tensions between these two interpersonal functions may account for mutually incongruent interpersonal responses to expressed anxiety, including mistargeted interpersonal regulation attempts. Because worry waxes and wanes over time as a function of other people's ongoing reactions, interpersonal interventions may help to alleviate some of its maladaptive consequences.

Can user testing of a clinical trial patient information sheet make it fit-for-purpose?--a randomized controlled trial.

BACKGROUND: The participant information sheet (PIS) provided to potential trial participants is a critical part of the process of valid consent. However, there is long-standing concern that these lengthy and complex documents are not fit-for-purpose. This has been supported recently through the application of a performance-based approach to testing and improving readability called user testing. This method is now widely used to improve patient medicine leaflets--determining whether people can find and understand key facts. This study applied for the first time a controlled design to determine whether a PIS developed through user testing had improved readability over the original, using a sheet from a UK trial in acute myeloid leukemia (AML16). METHODS: In the first phase the performance of the original PIS was tested on people in the target group for the trial. There were three rounds of testing including 50 people in total--with the information revised according to its performance after each of the first 2 rounds. In the second phase, the revised PIS was compared with the original in a parallel groups randomised controlled trial (RCT) A total of 123 participants were recruited and randomly allocated to read one version of the PIS to find and show understanding of 21 key facts. RESULTS: The first, developmental phase produced a revised PIS significantly altered in its wording and layout. In the second, trial phase 66% of participants who read the revised PIS were able to show understanding of all aspects of the trial, compared with 15% of those reading the original version (Odds Ratio 11.2; Chi-square = 31.5 p < .001). When asked to state a preference, 87.1% participants chose the revised PIS (Sign test p < .001). CONCLUSIONS: The original PIS for the AML16 trial may not have enabled valid consent. Combining performance-based user testing with expertise in writing for patients and information design led to a significantly improved and preferred information sheet. User testing is an efficient method for indicating strengths and weaknesses in trial information, and Research Ethics Committees and Institutional Review Boards should consider requesting such testing, to ensure that PIS are fit-for-purpose.

Negativity Spreads More than Positivity on Twitter After Both Positive and Negative Political Situations.

What type of emotional language spreads further in political discourses on social media? Previous research has focused on situations that primarily elicited negative emotions, showing that negative language tended to spread further. The current project extends existing knowledge by examining the spread of emotional language in response to both predominantly positive and negative political situations. In Study 1, we examined the spread of emotional language in tweets related to the winning and losing parties in the 2016 US elections, finding that increased negativity (but not positivity) predicted content sharing in both situations. In Study 2, we compared the spread of emotional language in two separate situations: the celebration of the US Supreme Court approval of same-sex marriage (positive) and the Ferguson unrest (negative), finding again that negativity spread further. These results shed light on the nature of political discourse and engagement. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-021-00057-7.

Emotional and behavioural reactions to moral transgressions: cross-cultural and individual variations in India and Britain.

Reactions to moral transgressions are subject to influence at both the cultural and individual levels. Transgressions against an individual's rights or against social conventions of hierarchy may elicit different reactions in individualistic and collectivistic cultures. In the current study, affective and behavioural reactions to transgressions of autonomy (rights) and community (hierarchy) were examined in India and Britain. Results revealed that although reactions to autonomy transgressions are similar in India and Britain, Indian participants express more moral outrage than do Britons in response to transgressions of community. Results also supported the contention of emotion-specificity in affective moral reaction: Participants in both India and Britain reported anger in response to autonomy transgressions, but contempt in response to violations of community. Importantly, these results extend previous research by demonstrating the importance of emotion specificity in moral reactions, as opposed to categorization or dilemma resolution. In addition, an individual difference measure of respect for persons was shown to moderate reactions to moral transgressions. Specifically, participants with high respect for persons were less negative to violators of the community ethic, but not the autonomy ethic. These findings highlight the importance of examining emotion-specific responses in the moral domain and introduce a significant individual difference variable, respect for persons, into the psychology of morality. Les réactions aux transgressions morales sont susceptibles d'influence à la fois aux niveaux culturel et individuel. Les transgressions contre les droits d'un individu ou contre les conventions sociales d'hiérarchie peuvent susciter de différentes réactions dans les cultures individualiste et collectiviste. Dans la présente étude, les réactions affective et comportementale aux transgressions de l'autonomie (droits) et de la communauté (hiérachie) ont été examinées en Inde et en Grande-Bretagne. Les résultats ont indiqué que, malgré la similitude des réactions aux transgressions de l'autonomie en Inde et en Grande-Bretagne, les participants indiens ont exprimé plus d'indignation morale que les britanniques en réponse aux transgressions de la communauté. Les résultats ont également appuyé la controverse de la spécifité de l'émotion dans la relation morale affective: les participants à la fois en Inde et en Grande-Bretagne ont rapporté de la colère en réponse aux transgressions de l'autonomie mais du mépris en réponse aux transgressions de la communauté. De façon importante, ces résultats ont élargi la recherche passée en démontrant l'importance de la spécificité de l'émotion dans les réactions morales, contrairement à la catégorisation ou à la solution du dilemme. En plus, il a été démontré qu'une mesure des différences individuelles du respect envers les personnes a modéré les réactions aux transgressions morales. Spécifiquement, les participants ayant un grand respect envers les personnes ont été moins négatifs envers les violateurs de l'éthique de la communauté mais pas de l'éthique de l'autonomie. Ces résultats soulignent l'importance d'examiner les réponses spécifique à l'émotion dans le domaine moral et introduisent une variable des différences individuelles, soit le respect envers les personnes, dans la psychologie de la moralité. Las reacciones a las transgresiones morales están sujetas a la influencia a niveles culturales e individuales. Las transgresiones contra los derechos individuales o convenciones sociales de jerarquías pueden provocar distintas reacciones en las culturas individualistas y colectivistas. En el presente estudio, se examinaron las reacciones afectivas y conductuales a las transgresiones contra la autonomía (derechos) y comunidad (jerarquía) en la India y en Gran Bretaña. Los resultados demostraron que, aunque las reacciones a las transgresiones contra la autonomía fueran parecidas en la India y en Gran Bretaña, los participantes indios expresaron más indignación moral que los británicos en la respuesta a la transgresión contra la comunidad. Los resultados también apoyan la visión de la especificidad emocional en la reacción afectiva moral: los participantes en la India y también en Gran Bretaña mostraron ira en respuesta a la transgresión contra la autonomía y desprecio en respuesta a la violación de la comunidad. De forma importante, estos resultados amplían los estudios anteriores demostrando la importancia de la especificidad emocional en las reacciones morales frente a la categorización o resolución de los dilemas. Adicionalmente, las medidas de las diferencias individuales en el respeto para personas moderan las reacciones a la transgresión moral. Específicamente, los participantes con alto respeto para personas fueron menos negativos a la hora de violar la ética de la comunidad pero no la ética de la autonomía. Estos resultados subrayan la importancia de estudiar las respuestas emocionales específicas en el dominio moral e introducen una variable de diferencias individuales significativas, respeto para personas, dentro de la psicología de la moralidad.

Affecting others: social appraisal and emotion contagion in everyday decision making.

In a diary study of interpersonal affect transfer, 41 participants reported on decisions involving other people over 3 weeks. Reported anxiety and excitement were reliably related to the perceived anxiety and excitement of another person who was present during decision making. Risk and importance appraisals partially mediated effects of other's anxiety on own anxiety as predicted by social appraisal theory. However, other's emotion remained a significant independent predictor of own emotion after controlling for appraisals, supporting the additional impact of more direct forms of affect transfer such as emotion contagion. Significant affect-transfer effects remained even after controlling for participants' perceptions of the other's emotion in addition to all measured appraisals, confirming that affect transfer does not require explicit registration of someone else's feelings. This research provides some of the clearest evidence for the operation of both social appraisal and automatic affect transfer in everyday social life.

Biased cognition in East Asian and Western cultures.

The majority of cognitive bias research has been conducted in Western cultures. We examined cross-cultural differences in cognitive biases, comparing Westerners' and East Asians' performance and acculturation following migration to the opposite culture. Two local (UK, Hong Kong) and four migrant (short-term and long-term migrants to each culture) samples completed culturally validated tasks measuring attentional and interpretation bias. Hong Kong residents were more positively biased than people living in the UK on several measures, consistent with the lower prevalence of psychological disorders in East Asia. Migrants to the UK had reduced positive biases on some tasks, while migrants to Hong Kong were more positive, compared to their respective home counterparts, consistent with acculturation in attention and interpretation biases. These data illustrate the importance of cultural validation of findings and, if replicated, would have implications for the mental health and well-being of migrants.

Intergroup emotional exchange: Ingroup guilt and outgroup anger increase resource allocation in trust games.

Intergroup exchanges are an integral part of social life but are compromised when one group pursues its interests at another group's expense. The present research investigates whether expressing emotion can mitigate the negative consequences of such actions. We examine how emotions communicated by either an ingroup or outgroup member following an ingroup member's breach of trust affect other ingroup members' feelings of guilt and pride, and subsequent allocation of resources. In both studies, groups of participants played a two-round trust game with another group. In round one, they observed a member of their own group failing to reciprocate a trusting move by the outgroup. In Study 1 (N = 85), an outgroup member then communicated anger or disappointment, whereas in Study 2 (N = 164), an ingroup member then communicated happiness or guilt. Comparisons with no-emotion control conditions revealed that expressions of outgroup anger and ingroup guilt increased participants' allocations to an outgroup member in round two. The effect of an outgroup member's anger expression was mediated by participants' diminished feelings of pride about the ingroup action, whereas the effect of an ingroup member's guilt expression was mediated by participants' own feelings of guilt. Taken together, these findings support a social appraisal approach and highlight the roles that pride and guilt can play in shaping intergroup resource allocations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Emotion Transfer, Emotion Regulation, and Empathy-Related Processes in Physician-Patient Interactions and Their Association With Physician Well-Being: A Theoretical Model.

Physicians experience many emotionally challenging situations in their professional lives, influencing their emotional state through emotion contagion or social appraisal processes. Successful emotion regulation is crucial to sustain health, enable well-being, foster resilience, and prevent burnout or compassion fatigue. Despite the alarmingly high rate of stress-related disorders in physicians, affecting not only physician well-being, but also outcomes such as physician performance, quality of care, or patient satisfaction, research on how to deal with emotionally challenging situations in physicians is lacking. Based on extant literature, the present article proposes a theoretical model depicting emotions, emotion regulation, and empathy-related processes and their relation to well-being in provider-client interactions. This model serves as a basis for future research and interventions aiming at improving physician well-being and professional functioning. As a first step, interviews with 21 psychiatrists were conducted. Results of qualitative and initial quantitative analyses provided detailed descriptions of the model's components confirming its usefulness for detecting mechanisms linking emotion regulation and well-being in psychiatrist-patient interactions. Additionally, results lend preliminary support for the validity of the model, suggesting that successful regulation of emotions (i.e., achieving a desired emotional state) elicited by cyclical transfer processes in provider-client interactions is associated with both short- and long-term well-being and resilience. Furthermore, empathy-related emotions and their regulation seem to be linked to well-being. Based on the results of the present study, a prospective longitudinal study is under preparation, which is intended to inform effective interventions targeting emotion transfer, empathy-related processes, and emotion regulation in physicians' professional lives. The model and results are also potentially applicable to other health care and social services providers.

Getting from situations to emotions: appraisal and other routes.

Comments on the original article by S. Siemer and R. Reisenzein regarding the process of emotion inference. When processing situational information, people can reach emotional conclusions without explicitly registering corresponding appraisals. Does this mean that appraisal cues must be guiding inference in less obvious ways? If one assumes that the emotional meaning of any situation depends on the protagonist's relation to what is happening, then emotion inference can never entirely bypass relational information. However, not all relational information is specifically appraisal-based. Further, actual emotion causation, like emotion inference, can involve explicit or implicit appraisals or even no appraisals at all. Indeed, humans do not first learn to associate emotions with situations by extracting appraisal information.

Comment: Respecifying Emotional Influence.

To what extent does the level of overlap between social appraisal and social referencing depend upon the particular definitions adopted when following different research agendas? I argue that processes of both kinds fall under the more inclusive heading of relation alignment. Relation alignment also covers emotional influence that is not mediated by the communication of appraisal. Similarities, interdependences, and distinctions between these various relation-alignment processes warrant further investigation.

Sharing concerns: Interpersonal worry regulation in romantic couples.

Two dyadic studies investigated interpersonal worry regulation in heterosexual relationships. In Study 1, we video-recorded 40 romantic couples discussing shared concerns. Male partners' worry positively predicted female partners' interpersonal calming attempts, and negatively predicted female partners' interpersonal alerting attempts (i.e., attempts to make their partners appreciate the seriousness of concerns). Video-cued recall data also indicated that changes in partner A's worry over time positively predicted partner B's motivation to reduce partner A's worry, and that this effect was stronger when B was the female partner. Study 2 was a dyadic survey of 100 couples. Individual differences in partner A's negative affect were positive predictors of partner B's interpersonal calming, and individual differences in partner A's expressive suppression were negative predictors of partner B's interpersonal calming. Further, individual differences in male partners' expressivity were significant positive predictors of female partners' interpersonal calming, and individual differences in male partners' reappraisal were significant positive predictors of female partners' interpersonal alerting. These findings suggest that interpersonal worry regulation relates to partners' expression and intrapersonal regulation of worry, but not equally for men and women. (PsycINFO Database Record

Laughter's influence on the intimacy of self-disclosure.

If laughter functions to build relationships between individuals, as current theory suggests, laughter should be linked to interpersonal behaviors that have been shown to be critical to relationship development. Given the importance of disclosing behaviors in facilitating the development of intense social bonds, it is possible that the act of laughing may temporarily influence the laugher's willingness to disclose personal information. We tested this hypothesis experimentally by comparing the characteristics of self-disclosing statements produced by those who had previously watched one of three video clips that differed in the extent to which they elicited laughter and positive affect. The results show that disclosure intimacy is significantly higher after laughter than in the control condition, suggesting that this effect may be due, at least in part, to laughter itself and not simply to a change in positive affect. However, the disclosure intimacy effect was only found for observers' ratings of participants' disclosures and was absent in the participants' own ratings. We suggest that laughter increases people's willingness to disclose, but that they may not necessarily be aware that it is doing so.