Heterogeneity in Arbuscular Mycorrhizal Fungi and Plant Communities of the Brazilian Cerrado, Transitional Areas toward the Caatinga, and the Atlantic Forest.

The Cerrado is the most diverse tropical savanna worldwide and the second-largest biome in South America. The objective of this study was to understand the heterogeneity and dynamics of arbuscular mycorrhizal fungi (AMF) in different types of natural Cerrado vegetation and areas that are transitioning to dryer savannas or tropical rainforests and to elucidate the driving factors responsible for the differences between these ecosystems. Twenty-one natural sites were investigated, including typical Cerrado forest, typical Caatinga, Atlantic Rainforest, transitions between Cerrado and Caatinga, Cerrado areas near Caatinga or rainforest, and Carrasco sites. Spores were extracted from the soils, counted, and morphologically analyzed. In total, 82 AMF species were detected. AMF species richness varied between 36 and 51, with the highest richness found in the area transitioning between Cerrado and Caatinga, followed by areas of Cerrado close to Caatinga and typical Cerrado forest. The types of Cerrado vegetation and the areas transitioning to the Caatinga shared the highest numbers of AMF species (32-38). Vegetation, along with chemical and physical soil parameters, affected the AMF communities, which may also result from seasonal rainfall patterns. The Cerrado has a great AMF diversity and is, consequently, a natural refuge for AMF. The plant and microbial communities as well as the diversity of habitats require urgent protection within the Cerrado, as it represents a key AMF hotspot.

Predicting Physical Activity in Survivors of Breast Cancer: the Health Action Process Approach at the Intrapersonal Level.

BACKGROUND: Benefits have been established for regular physical activity (PA) and exercise after breast cancer, but a decline of PA has also been a reported result of breast cancer diagnosis and treatments. The Health Action Process Approach (HAPA) model has been shown to predict various health behaviors, but few studies have tested it at the intrapersonal level. The aim of the present study was to test whether the HAPA constructs that are well confirmed at the interpersonal level also hold at the intrapersonal level in a group of women survivors of breast cancer. METHOD: PA behaviors (N = 338) by nine survivors of breast cancer were observed for 6 weeks, and the associations between the HAPA constructs and PA over time were examined. Participants completed a questionnaire with the HAPA constructs related to PA behavior (direct step count and self-reported). RESULTS: A multilevel model of behavior prediction found that optimistic beliefs about ability to initiate and maintain PA (self-efficacy) were positively related to intentions to be active, and these intentions predicted plans to be active. PA was directly and positively predicted by planning and by confidence in the ability to resume PA after a break. CONCLUSION: Self-efficacy and planning are associated with PA behavior within women survivors of breast cancer over time, which was not the case for the outcome expectancies, social support, and action control at this intrapersonal level. A multilevel approach for psychological predictors of PA can be useful in grounding interventions for survivors of breast cancer.

Promoting physical activity within breast cancer survivors using behavior change techniques: N-of-1 randomized controlled trials.

Survivors of breast cancer are an important target for health promotion interventions, and physical activity (PA) is recommended with benefits being well established. More and more behavior theory guided interventions are planned and tailored to the individuals, targeting specifics needs and personal characteristics. We aimed to test the effectiveness of two behavior change techniques [coping planning (CP) and self-monitoring (SM)] for promoting PA in survivors of breast cancer, using a single-case design. In a powerful multiple sample N-of-1 RCT, 10 women post-breast cancer (M = 52.8 years) were randomly assigned to four experimental conditions (CP and/or SM, control) for 60 days and their daily step count was observed. The overall effects were analyzed using multilevel time-series with random intercepts. Time-series regression models and supplementary pairwise analyses were conducted for individuals. Multilevel analyses showed significant effects of CP and SM. Single-case analyses showed that six participants walked significantly more on the intervention days, that combined interventions were effective for five participants, but two participants had better results with the other two conditions. Combined self-regulatory techniques were more effective in promoting PA however, individual variability should be considered in future studies with survivors of breast cancer. Retrospectively registered: https://osf.io/eakjy/?view_only=81bf3dc084a0410a8ea28265e0f3c360, 31-01-2023.(raise query).

Plasmatic endocannabinoids are decreased in subjects with ultra-high risk of psychosis.

The onset of frank psychosis is usually preceded by a prodromal phase characterized by attenuated psychotic symptoms. Currently, research on schizophrenia prodromal phase (ultra-high risk for psychosis [UHR]) has focused on the risk of developing psychosis, on the transition to full blown psychosis and on its prediction. Neurobiological differences between UHR individuals who fully recover (remitters) versus those who show persistent/progressive prodromal symptoms (nonremitters) have been little explored. The endocannabinoid system constitutes a neuromodulatory system that plays a major role in brain development, synaptic plasticity, emotional behaviours and cognition. It comprises two cannabinoid receptors (CB1/CB2), two endocannabinoid ligands, arachidonylethanolamide (AEA) and 2-arachidonoylglycerol (2AG) along with their inactivation enzymes. Despite much evidence that the endocannabinoid system is imbalanced during psychosis, very little is known about it in UHR. Therefore, we aimed to quantify the plasma endocannabinoid levels in UHR and healthy controls (HC) and verify if these metabolites could differentiate between remitters and nonremitters. Circulating concentrations of AEA (p = .003) and 2AG (p < .001) were lower in UHR when compared with HC, with no difference between remitters and nonremitters. Regarding clinical evolution, it was observed that out of 91 UHRs initially considered, 16 had psychiatric complaints (3 years of follow-up). Considering those subjects, there were weak correlations between clinical parameters and plasma concentrations of endocannabinoids. Our results suggest that the endocannabinoids are imbalanced before frank psychosis and that changes can be seen in plasma of UHR individuals. These molecules proved to be potential biomarkers to identify individuals in the prodromal phase of psychosis.

COVID-19 anxiety scale (CAS): Development and psychometric properties.

The objective of the present research is to develop and validate the COVID-19 Anxiety Scale (CAS). We conducted three studies to gather evidence regarding content and construct validity, as well to evaluate the reliability of the measure. Study 1 is subdivided into two studies. In Study 1a, we analyze the content validity of the new measure through content expert analysis (N = 10 expert raters). In Study 1b (N = 30), we perform a pilot study with a sample from the target population. In Study 2 (N = 352), we explored the unifactorial structure of the measure, and analyzed its internal consistency verified. Finally, in Study 3 (N = 200), we assess the adequacy of the factor structure and gather evidence on convergent-discriminant validity and gender-scale invariance. In summary, our results demonstrate that CAS is a reliable and adequate instrument to assess COVID-19 related anxiety.

Increased PLA2 activity in individuals at ultra-high risk for psychosis.

Phospholipase A2 is the main enzyme in the metabolism of membrane phospholipids. It comprises a family of enzymes divided into iPLA2, cPLA2 and sPLA2. Studies have reported increased PLA2 activity in psychotic patients, which suggests an accelerated breakdown of membrane phospholipids. In the present study we investigated whether increased PLA2 activity is also present in individuals at ultra-high risk (UHR) for psychosis. One-hundred fifty adults were included in this study (85 UHR and 65 controls). UHR was assessed using the "structured interview for prodromal syndromes". PLA2 activity was determined in platelets by a radio-enzymatic assay. We found in UHR individuals increased activities of iPLA2 (p < 0.001) and cPLA2 (p = 0.012) as compared to controls. No correlations were found between socio-demographic and clinical parameters and PLA2 activity. Our findings suggest that increased PLA2 activities may be useful as a biological risk-marker for psychotic disorders.

Anxiety associated with COVID-19 and concerns about death: Impacts on psychological well-being.

Situations of public calamity, such as that caused by COVID-19 pandemic, strongly impact mental health, especially among people who feel most anxious about the imminence of death, as highlighted by the Terror Management Theory. In this research, we investigated how and under which conditions concerns about death itself and anxiety are related to psychological well-being. Specifically, we assessed the role of fear caused by the prominence of death (contextual and dispositional) in anxiety and well-being during the pandemic. Participants were 352 Brazilians, who answered a measurement of fear of death and read a news story about COVID-19. The manipulated news brought the idea of death to prominence (vs. non-prominence). After reading the news, the participants answered scales of anxiety and psychological well-being. The results showed that individual differences in fear of death related to well-being, and that this relationship was mediated by anxiety in face of COVID-19. Contrastingly, the manipulation of the salience of death in the news did not affect this relationship. These results contribute to the understanding of a psychological process related with fluctuations in individuals' well-being during the pandemic, offering insights for future studies that can promote better coping conditions during this period of world crisis.

Clear-Cut Terms and Culture-Sensitive Characteristics of Distinctive Casual Sexual Relationships in Portuguese Emerging Adults.

Casual sexual relationships (CSR) are increasingly common but limited empirical research has addressed their terminology and distinctive characteristics. This study sought to identify the most clear-cut terms and to consider how culture-sensitive characteristics distinguish casual sexual relationships among Portuguese emerging adults (N = 262, 18-29 years old). We combined two qualitative studies - one by association and another by free recall - to ascertain the clarity of the terms, plus a quantitative study to further characterize and differentiate them. Participants were asked to match descriptions of CSRs with the respective terms by which they are known (Study 1). The same was investigated using an evocation task requesting that participants produce the terms by which the described CSRs are known (Study 2). Binary logistic regressions were performed to analyze the associations between encounters and labels chosen, taking the effect of gender and age into account. In the third study, participants rated the degree to which eight characteristics were present in the types of CSR, a simultaneous task that led to greater understanding of their descriptive and differentiating characteristics. Multivariate analysis of variance was used, with gender and age as covariates. We conclude that two types of CSR - friends with benefits and one-night stand - and, to a lesser extent, making out, are understood and associated with consensual labels, also found by free-recall. These CSRs proved to be distinct, as they are understood as more different than similar in a set of psychoemotional, behavioral, and sexual characteristics. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12119-021-09859-0.

Self-regulation in oral hygiene behaviours in adults with gingivitis: The mediating role of coping planning and action control.

AIM: This study investigates the joint role of volitional predictors of oral hygiene behaviours of flossing and brushing in adults with gingivitis, framed by the Health Action Process Approach model (HAPA). MATERIALS AND METHODS: In a longitudinal online survey, 201 participants aged 18-75, of which 56.7% were women, completed assessments at baseline(T1), 2 weeks(T2) and 4 months(T3). Oral hygiene behaviours(OH) (brushing and flossing) and social cognitive determinants of behaviour in the HAPA: action and maintenance self-efficacy(ASE & MSE), intention(INT), coping planning(CP) and action control(AC) were evaluated. Structural equation modelling was used to test a series of three nested models. In Model 1, action self-efficacy would determine MSE and INT, and INT would determine OH; in Model 2, INT would determine both CP and AC and the two OH behaviours; and in Model 3, CP and AC would be sequential mediators between INT and OH. RESULTS: Model 3, predicting a mediating process from intention to behaviour via coping planning and action control, showed the best fit according to the fit indices and explained more of the variance in dental hygiene. The mediating role of coping planning and action control between intention and oral hygiene behaviours was thus confirmed. Importantly, coping planning did not mediate between intention and oral hygiene behaviours, which means that oral hygiene intention influences action control through coping planning, and both sequentially mediate this influence on behaviour. CONCLUSIONS: For individuals who are not yet following the recommendations for specific oral hygiene behaviours, coping planning and action control represent psychological mechanisms by which intentions are put into practice.

Justifying treatment bias: The legitimizing role of threat perception and immigrant-provider contact in healthcare.

OBJECTIVE: Immigrants tend to receive a lower quality of healthcare, which can be a sign of healthcare bias. We examined whether this bias in medical care is associated with a legitimizing process involving two psychosocial factors: threat perception and level of intergroup contact. METHOD: One hundred eighty six Portuguese health professionals (55.6% clinicians; 44.4% nurses; 78.5% female; Mage = 45.83, range = 23 and 71) completed a questionnaire on prejudiced attitudes toward immigrants, perceptions of health-specific threats, bias in medical practice and level of contact with immigrant patients. RESULTS: For healthcare providers who have more contact with immigrant patients, the perceived health threat mediated the relationship between prejudiced attitudes and treatment bias. In contrast, for healthcare providers with less contact with immigrant patients, the perceived threat was not associated with treatment bias. CONCLUSIONS: These findings help to understand the persistence of lower quality medical treatment among immigrants, providing guidelines for future research. In particular, they suggest that perceiving immigrants as a threat to public health is indicative of the providers' engagement in a legitimizing process of self-reported biased treatment, making this engagement necessary only for providers with greater levels of contact with immigrant patients. (PsycINFO Database Record

Development and Initial Validation of the Beliefs About Sexual Functioning Scale: A Gender Invariant Measure.

BACKGROUND: Past research on cognitive models of sexual functioning has focused on sexual beliefs as an important vulnerability factor for sexual dysfunction. However, the existing measurements of sexual beliefs are lengthy and entangle beliefs about sexual functioning with moral beliefs and ideas about sexuality. Furthermore, they have female and male versions, which does not allow for sex comparisons or dyadic research with heterosexual couples. AIM: To describe the development and validation of the Beliefs About Sexual Functioning Scale (BASEF), which assesses beliefs about sexual functioning in men and women. METHODS: This study included two cross-sectional online studies with adults in heterosexual dyadic committed and exclusive relationships. In study 1 (sample A, n = 274, mean age = 32.27 years; sample B, n = 114, mean age = 30.6 years), the factorial validity of the BASEF was analyzed through an exploratory factor analysis with an initial poll of 51 items, followed by a test of its structure in a confirmatory factor analysis. In study 2 (n = 426, mean age = 31.5 years), the factorial equivalence of the BASEF was tested across sexes and its association with total scores of sexual functioning was analyzed. OUTCOME: The main outcome was a new instrument for measurement of beliefs about sexual functioning. RESULTS: In study 1, 15 items indicating 5 factors were retained. The structure was confirmed by confirmatory factor analysis, establishing its factorial validity with the five factors aggregated in a second-order latent variable. In study 2, the equivalence of the BASEF was demonstrated across sexes and its association with theoretically related measurements, the International Index of Erectile Function and the Female Sexual Function Index, was supported. CLINICAL IMPLICATIONS: This new measurement could be useful to evaluate clients and design interventions that take into account similarity and discrepancy in sexual beliefs in couples, such as those interventions framed in cognitive and systemic clinical models. STRENGTHS AND LIMITATIONS: This study presents a new measurement of beliefs about sexual functioning suited to address an equivalent set of beliefs for men and women. In future studies, the scale will be useful to compare the unique role of these same beliefs in the sexual outcomes of men and women. One major limitation is the lack of examination of the BASEF criterion validity with a clinical sample. CONCLUSIONS: Results are indicative of a brief, valid, and reliable sex-invariant measurement of beliefs about sexual functioning that enables testing of cognitive models of sexual functioning in men and women in clinical and research settings. Pascoal PM, Alvarez M-J, Pereira CR, Nobre P. Development and Initial Validation of the Beliefs About Sexual Functioning Scale: A Gender Invariant Measure. J Sex Med 2017;14:613-623.

Partners' Similarity in Differentiation of Self is Associated With Higher Sexual Desire: A Quantitative Dyadic Study.

The relationship between sexual desire and differentiation of self in couples has been frequently discussed in clinical literature but lacks empirical support. This exploratory study investigates the associations between individual and dyadic levels of sexual desire, differentiation of self, and couple satisfaction. Similarities and discrepancies in sexual desire and differentiation of self between partners were especially targeted. Partners were expected to have a lower discrepancy of differentiation of self than unrelated individuals (Bowen's similarity hypothesis). Partners' discrepancy in differentiation of self was expected to be negatively associated with sexual desire, and higher levels of sexual desire and differentiation in the dyad were expected be positively associated with couple satisfaction. Results suggest that partners' similarity regarding differentiation of self predicted individual sexual desire. Other findings suggest that couple satisfaction was positively associated with both sexual desire and differentiation of self. Limitations and clinical implications are discussed.

A multilevel perspective to explain recycling behaviour in communities.

Previous research on the motivation for environmentally responsible behaviour has focused mainly on individual variables, rather than organizational or collective variables. Therefore, the results of those studies are hardly applicable to environmental management. This study considers individual, collective, and organizational variables together that contribute to the management of environmental waste. The main aim is to identify, through the development of a multilevel model, those predictive variables of recycling behaviour that help organizations to increase the recycling rates in their communities. Individual (age, gender, educational level, self-efficacy with respect to residential recycling, individual recycling behaviour), organizational (satisfaction with the quality of the service provided by a recycling company), and collective (community recycling rates, number of inhabitants, community efficacy beliefs) motivational factors relevant to recycling behaviour were analysed. A sample of 1501 residents from 55 localities was surveyed. The results of multilevel analyses indicated that there was significant variability within and between localities. Interactions between variables at the level of the individual (e.g. satisfaction with service quality) and variables at the level of the collective (e.g. community efficacy) predicted recycling behaviour in localities with low and high community recycling rates and large and small populations. The interactions showed that the relationship between self-efficacy and recycling is stronger in localities with weak community efficacy beliefs than in communities with strong beliefs. The findings show that the relationship between satisfaction with service quality and recycling behaviour is stronger in localities with strong community efficacy beliefs than in communities with weaker beliefs and a smaller population. The results are discussed accordingly in relation to theory and possible contribution to waste management. Those findings may be incorporated in national and international environmental policies in order to promote environmentally responsible behaviour in citizenship.

Categorisation salience and ingroup bias: the buffering role of a multicultural ideology.

The current work sought to test the moderating role of a multicultural ideology on the relationship between categorisation salience and ingroup bias. Accordingly, in one experimental study, we manipulated categorisation salience and the accessibility of a multicultural ideology, and measured intergroup attitudes. Results show that categorisation salience only leads to ingroup bias when a multiculturalism (MC) ideology is not made salient. Thus, MC ideology attenuates the negative effects of categorisation salience on ingroup bias. These results pertain to social psychology in general showing that the cognitive processes should be construed within the framework of ideological contexts.

Healthcare providers' psychological investment in clinical recommendations: Investigating the role of implicit racial attitudes.

Racial disparities in clinical recommendations can result in racial disparities in health. While healthcare providers' implicit racial attitudes (affective component of bias) are theorized to be one major factor contributing to racial disparities in clinical recommendations, empirical evidence to support the link is lacking. This study aimed to bridge this gap by moving beyond the standard approach of operationalizing the quality of clinical recommendations as a guideline-consistent vs. -inconsistent dichotomy. The present secondary study examined the role of provider implicit racial attitudes in the quality of clinical recommendations, operationalized as behaviors reflecting providers' psychological investment in patient care (i.e., number of words used to describe clinical recommendations, and number of treatment options recommended). Two-hundred-and-ten White medical trainees reviewed a clinical vignette of either a White or Black male patient and provided clinical recommendations. Their implicit racial attitudes were evaluated using the Implicit Association Test. Participants with more biased implicit racial attitudes (i.e., stronger implicit preference for White vs. Black individuals) used fewer words to describe their clinical recommendations and provided fewer clinical recommendations for the Black (vs. White) patient, while there were no significant differences between Black and White patients among participants with less biased implicit racial attitudes. These results illustrate the insidious impact of implicit racial attitudes in healthcare provision and underscore the need for researchers to consider the complex, nuanced ways in which provider implicit racial attitudes might manifest in clinical decision-making.

Condom use across casual and committed relationships: The role of relationship characteristics.

BACKGROUND: While the existence of a complex variety of casual sexual relationships (CSRs) has been acknowledged, studies rarely describe the prevalence of condom use across these relationships or how their hybrid nature, specifically relationship characteristics, affect condom use. This study aims to describe condom use within committed relationships and various types of casual sexual relationships (CSRs), examining the influence of relationship characteristics on condom use among culturally validated relationship types (committed, friends with benefits, hookups, booty call). METHODS: Emerging adults (N = 728, 18-29 years, M = 22.56; SD = 3.01) completed a survey with four blocks: sociodemographics; brief sexual history; relationships over the previous year; and current relationship, assessing relationship type, ten relationship characteristics (e.g., commitment, emotional and sexual exclusivity, partner acquaintance, sexual involvement) and condom use (vaginal, oral, and anal), operationalized by three measures (use at last encounter, likert-type scale and percentage of use). RESULTS: The results showed patterns in condom use by relationship type and illuminated how relationship characteristics-grouped into three factors: commitment, intimacy, and sexuality-mediate condom use. Condom use was more frequent in vaginal than anal and oral sex, and less frequent in committed relationships. No significant differences were found in condom use in vaginal sex between committed relationships and hookups, with condom in these relationships being significantly lower than in booty call. Intimacy mediated between all contrasts tested and condom use in vaginal sex, while sexuality mediated between committed vs. CSRs and condom use in anal and oral sex. CONCLUSIONS: Findings point to the need of considering the diversity of CSRs for understanding condom use and highlight the role of intimacy as a relevant mechanism associated with condom use in vaginal sex and of sexuality in oral and anal sex, which should be taken into consideration in the tailoring of health promoting efforts.

Distributive justice criteria and social categorization processes predict healthcare allocation bias.

OBJECTIVES: Drawing on theories of distributive justice and intergroup discrimination, we examined how much distributive justice criterion and racial group membership contribute to bias in healthcare allocation decisions, by testing a theoretical model that specifies perceived stereotypicality and individual responsibility as a serial mediation process in the relationship between disease's contraction controllability (controllable vs. non-controllable) and bias in medical decision-making. METHOD: White Portuguese medical students (N = 213) participated in an online experimental study conducted in two phases. In phase 1, we manipulated the cause of disease contagion and the salience of patient's racial categorization, and measured the stereotypicality of behaviour. In phase 2, we assessed perceived responsibility and likelihood of recommending medical treatment. RESULTS: Controllable (vs. non-controllable) contraction behaviours in phase 1 were perceived as more stereotypic. As a spillover effect, more stereotypical behaviours in phase 1 predicted more patient's responsibility for their disease in phase 2. Importantly, controllable behaviours of disease contraction in phase 1 negatively affected recommendations for medical treatment in phase 2; and this negative effect was serially mediated by the stereotypicality of behaviour and patient responsibility. Furthermore, patients' skin colour moderated this process, meaning that perceptions of controllable behaviour as more stereotypic were stronger for Black than for White patients. CONCLUSIONS: This research shows how stereotyping and social categorization bias allocation decisions through the patient's level of responsibility in decision-making processes. The findings are discussed in light of principles of distributive justice and the literature on intergroup relations with respect to racial disparities in health care.

Development and Validation of the Secondary Victimization Scale.

Sexual violence is ubiquitous in the history of human relationships, with the victim being perceived as responsible for their own misfortune. This phenomenon is labelled secondary victimization and is manifested in blaming, minimizing the suffering, and avoiding the victim. This article presents evidence of the validity of a scale that measures individual differences in these three types of secondary victimization of rape victims. In Study 1, we developed the scale items and analyzed their content validity. In Study 2, we carried out an exploratory analysis of its factorial structure and verified the set-up of the items in three theoretically predicted factors (blaming, minimizing the suffering, and avoiding the victim), which had convergent validity with the Rape Myth Acceptance Scale, and discriminant validity with the Big Five Personality Traits, in addition to having concurrent validity with the Belief in a Just World Scale (BJWS). In Study 3, we confirmed this tri-factor structure using confirmatory analysis. In Study 4, we analyzed the predictive validity of the Secondary Victimization Scale (SVS), proposing the hypothesis that secondary victimization mediates the effect of BJWS on the participants' behavior towards a rape victim. The summary of the results shows consistent evidence of the SVS's validity.

Multiple Casual Sex Scripts: Shared Beliefs about Behavior among Portuguese Emerging Adults.

Objective: Empirical research to differentiate casual sex scripts is still limited. We aimed to ascertain the sexual scripts for three main types of casual sexual relationships: hookup, friends with benefits and one-night stands. Methods: Through a mixed-method approach, we performed a study consisting in two sequential tasks to (1) complete three lists of script actions, and (2) identify the most agreed-upon actions for each casual sexual relationship. Results: An important number of actions and events were identified for the three casual sexual scripts, reflecting a high level of elaboration and structure. Following a cognitive-script methodology, the actions retained for the content of the script for each casual sexual relationship were those obtaining at least 60% in respect to the mean of their centrality to the encounter. Only 16.5% of actions were shared among the three scripts, demonstrating their distinctiveness. Conclusion: Knowledge about the different casual sex scripts can be used to develop relational and personal skills within CSRs and decrease unwanted experiences such as condomless sex.

Intergroup time bias and aversive racism in the medical context.

Time is fundamental to organizing all aspects of human life. When invested in relationships, it has a psychological meaning as it indicates how much individuals value others and their interest in maintaining social relationships. Previous research has identified an intergroup time bias (ITB) in racialized social relations, defined as a discriminatory behavior in which White individuals invest more time in evaluating White than Black individuals. This research proposes an aversive racism explanation for the ITB effect and examines its consequences in the medical context. In four experimental studies (N = 434), we found that White medical trainees invested more time in forming impressions of White (vs. Black) male patients. Study 5 (N = 193) further revealed more time investment in diagnosing, assessing pain, and prescribing opioids for White than Black male patients. This biased time effect mediated the impact of patients' skin color on health care outcomes, leading to greater diagnostic accuracy and pain perception, and lower opioid prescriptions. A meta-analytical integration of the results (Study 6) confirmed the ITB effect reliability across experiments and that it is stronger in participants with an aversive racist profile (vs. consistently prejudiced or nonprejudiced). These findings provide the first evidence that bias in time investment favoring White (vs. Black) patients is associated with aversive racism and impacts medical health care outcomes. Furthermore, these results offer insights into the sociopsychological meaning of time investment in health care and provide a theoretical explanation for an understudied insidious form of discrimination that is critical to comprehending the persistency of racial health care disparities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).