Investigating how self-esteem moderates grandiose narcissism's interpersonal orientation.

OBJECTIVE: Most previous research has treated grandiose narcissism and self-esteem as additive predictors of outcomes, but some theory and evidence suggests they may sometimes interact to predict outcomes. Unfortunately, the nature of this interaction is unclear; we suggest a framework to conceptualize the interaction and test it vis-à-vis the interpersonal circumplex framework. METHOD: Participants (N = 598; Mage  = 38.39; 327 females; 72.1% White) reported their levels of grandiose narcissism and self-esteem and completed interpersonal circumplex measures of efficacies, values, problems, and sensitivities. RESULTS: As self-esteem decreased, grandiose narcissism related (a) more negatively to communal efficacies and values and (b) more positively to sensitivity to others' communal behaviors. Also as self-esteem decreased, unexpectedly, grandiose narcissism related (a) more positively to agentic efficacies and problems and (b) more negatively to sensitivity to others' agentic behaviors. CONCLUSION: Overall, the present findings generally support using interaction models over additive models of grandiose narcissism and self-esteem in interpersonal contexts, suggesting that grandiose narcissism becomes generally less communal, more agentic, and more interpersonally problematic as self-esteem decreases.

Self-esteem mediates effects of normal and pathological personality traits on subjective well-being.

As subjective well-being is foundational to understanding people, researchers have sought to uncover its correlates. Some theorizing proposes that effects of broad personality traits on subjective well-being constructs are mediated by self-esteem; unfortunately, evidence pertaining to this idea has been limited to the study of "normal" broad personality traits and limited measures of subjective well-being. Here, we provided a more comprehensive test of this theory, and we examined the dominance of self-esteem over normal and pathological broad personality traits in predicting an array of subjective well-being constructs. In a primarily college sample (N = 272), we found that self-esteem generally mediated the effects of all Five-Factor Model (FFM) traits except Agreeableness and all pathological personality traits-represented in the Personality Inventory of The Diagnostic and Statistical Manual of Mental Disorders traits (5th edition; PID-5)-except Antagonism on a set of subjective well-being measures; moreover, dominance analyses showed that self-esteem was generally more important than any FFM or PID-5 trait in predicting the subjective well-being measures. We discuss limitations of our study along with some of its basic and applied implications.

Deprived and Grandiose Explanations for Psychological Entitlement: Implications for Theory and Measurement.

This work aimed to corroborate "vulnerable-based" and "grandiose-based" forms of psychological entitlement by amending the Psychological Entitlement Scale (PES; Campbell, Bonacci, Shelton, Exline, & Bushman, 2004), a popular unidimensional index of psychological entitlement. In 2 studies, participants completed PES items amended to include both deprived-identity-based and grandiose-identity-based rationales for item agreement and various individual-difference measures of constructs related to entitlement, self-evaluation, personality, and interpersonal orientations. The modified PES yielded a grandiose-based (PES-G) and vulnerable-based (PES-V) entitlement scale that showed good psychometric qualities. PES-G and PES-V converged well on core features of psychological entitlement (e.g., antagonistic outcomes) but generally failed to converge on self-evaluation, acquisitive versus defensive forms of entitlement, behavioral inhibition system and behavioral activation system, and interpersonal behavior indicative of claiming and cultivating grandiose versus deprived identities. This research supports the presence of grandiose-based and vulnerable-based entitlement forms, demonstrates a measurement technique to tap these forms, and suggests some theoretical implications.

Profiles and profile comparisons between Dark Triad constructs on self-presentation tactic usage and tactic beliefs.

OBJECTIVE: The present research profiled antisocial personality constructs in relation to tactical self-presentation behaviors and various beliefs associated with such tactical behavior. METHOD: An MTurk sample (N = 524; Mage  = 37.89; 61% female) completed indices of the Dark Triad (DT; narcissism, Machiavellianism, psychopathy) and self-reported their use of various self-presentation tactics, their beliefs about the subjective logic for executing the tactics (which encompassed ratings of the tactics' utility, ease of execution, and normativity), and the potential for each tactic to arouse self-recrimination. RESULTS: Results revealed high convergence between the DT constructs on a relatively malignant approach to self-presentation. DT constructs related to enhanced usage, enhanced subjective logic, and reduced self-recrimination ratings for all the tactics, except pro-social ones (exemplification and apologizing). Nonetheless, results also revealed some notable anticipated instances of nonconvergences between the DT constructs and tactic usage. CONCLUSIONS: The findings highlight that DT constructs function rather similarly at the level of self-presentation and suggest value in considering the DT constructs as indicative of strategic, subjectively logical image cultivation and defense behavior.

Image intensive soft tissue sarcoma surveillance uncovers pathology earlier than patient complaints but with frequent initially indeterminate lesions.

INTRODUCTION: Post-treatment surveillance follow-up soft-tissue sarcomas is controversial. Protocols are highly variable. This study retrospectively evaluates an image intense protocol to assess benefits of identifying true pathology compared to incidental findings. METHODS: A retrospective chart review was conducted on a single orthopedic oncologist's soft tissue sarcoma patients under a consistent protocol (TAD). Study population included patients who underwent resection of non-metastatic soft tissue sarcoma (AJCC stages I-III) and either died within surveillance period or completed 5 years of follow-up. RESULTS: Thirty-nine patients met the strict study criteria. 24/39 (61.5%) patients were identified to have a local recurrence (6), chest metastasis (6), isolated distant recurrence (9), or new primary tumor (3). Of those 24 patients with true pathology, 13 (54%) or 33% (13/39) of all patients potentially benefited from discovery via imaging before patient complaint. Chest CT was the first to reveal all lung metastases. For balance, 32/39 (82%) patients had at least 1 initially "indeterminate" lesion on imaging. Of those, 91% (29/32)-74% of all patients (29/39)-proved to be inconsequential by final follow up. CONCLUSION: Of the true pathology identified, over half were not evident on clinical presentation, emphasizing the importance of a routine surveillance. However, an image intense surveillance program has a high rate of initially indeterminate findings. J. Surg. Oncol. 2016;113:818-822. © 2016 Wiley Periodicals, Inc.

Toward a Mechanistic Understanding of Environmentally Forced Zoonotic Disease Emergence: Sin Nombre Hantavirus.

Understanding the environmental drivers of zoonotic reservoir and human interactions is crucial to understanding disease risk, but these drivers are poorly predicted. We propose a mechanistic understanding of human-reservoir interactions, using hantavirus pulmonary syndrome as a case study. Crucial processes underpinning the disease's incidence remain poorly studied, including the connectivity among natural and peridomestic deer mouse host activity, virus transmission, and human exposure. We found that disease cases were greatest in arid states and declined exponentially with increasing precipitation. Within arid environments, relatively rare climatic conditions (e.g., El Niño) are associated with increased rainfall and reservoir abundance, producing more frequent virus transmission and host dispersal. We suggest that deer mice increase their occupancy of peridomestic structures during spring-summer, amplifying intraspecific transmission and human infection risk. Disease incidence in arid states may increase with predicted climatic changes. Mechanistic approaches incorporating reservoir behavior, reservoir-human interactions, and pathogen spillover could enhance our understanding of global hantavirus ecology, with applications to other directly transmitted zoonoses.

Orthopedic Surgery Residents: How Much Do They Know About Occupational Therapy?

Background Orthopedic hand surgeons rely on occupational therapy (OT) as a crucial part of rehabilitation following injury or surgery. Therefore, orthopedic surgeons should understand the full range of OT services. There is limited prior research on orthopedic residents' understanding of OT in the United States. The main goal of this study is to examine how well orthopedic surgery residents grasp and perceive the role of OT, particularly in hand surgery, as integrated into their educational curriculum. Methods The study included all orthopedic surgery residents from a single institution (Columbia University, New York) during 2022-2023. We obtained permission from the Institutional Review Board, Department Chair, and Program Director to recruit participants. Eligible residents who agreed to participate completed questionnaires regarding their understanding of the role of OT in orthopedic surgery. Results Thirty subjects met the inclusion criteria. The total response rate from the residents was 14/30 (47%). The residents reported a mediocre level of familiarity with OT while also rating 4.5/5 the importance of OT in hand surgery without significant difference between postgraduate year groups. 11/14 residents reported no formal training concerning the role of OT in hand surgery. 12/14 residents reported that it would be helpful to spend time with an occupational therapist. Conclusions This study revealed the lack of confidence residents expressed regarding occupational therapists' roles. All residents recognized the importance of OT in hand surgery and expressed interest in shadowing occupational therapists. Residents of all levels acknowledge the crucial partnership between orthopedists and occupational therapists but lack formal education about the therapist's scope and role.

Probabilistic coherence, logical consistency, and Bayesian learning: Neural language models as epistemic agents.

It is argued that suitably trained neural language models exhibit key properties of epistemic agency: they hold probabilistically coherent and logically consistent degrees of belief, which they can rationally revise in the face of novel evidence. To this purpose, we conduct computational experiments with rankers: T5 models [Raffel et al. 2020] that are pretrained on carefully designed synthetic corpora. Moreover, we introduce a procedure for eliciting a model's degrees of belief, and define numerical metrics that measure the extent to which given degrees of belief violate (probabilistic, logical, and Bayesian) rationality constraints. While pretrained rankers are found to suffer from global inconsistency (in agreement with, e.g., [Jang et al. 2021]), we observe that subsequent self-training on auto-generated texts allows rankers to gradually obtain a probabilistically coherent belief system that is aligned with logical constraints. In addition, such self-training is found to have a pivotal role in rational evidential learning, too, for it seems to enable rankers to propagate a novel evidence item through their belief systems, successively re-adjusting individual degrees of belief. All this, we conclude, confirms the Rationality Hypothesis, i.e., the claim that suitable trained NLMs may exhibit advanced rational skills. We suggest that this hypothesis has empirical, yet also normative and conceptual ramifications far beyond the practical linguistic problems NLMs have originally been designed to solve.

Radiographic Outcomes of Titanium Augment vs Bone Graft in Lateral Column Lengthening for Adult-Acquired Flatfoot Deformity.

Background: Lateral column lengthening (LCL) is a surgical procedure used to manage forefoot abduction and, in theory, also increases the longitudinal arch by plantarflexion of the first ray through tensioning the peroneus longus for patients with stage IIB adult acquired flatfoot deformity (AAFD). This procedure utilizes an opening wedge osteotomy of the calcaneus, which is then filled with autograft, allograft, or a porous metal wedge. The primary aim of this study was to compare the radiographic outcomes of these different bone substitutes following LCL for stage IIB AAFD. Methods: We conducted a retrospective review of all patients who underwent LCL from October 2008 until October 2018. Preoperative weightbearing radiographs, initial postoperative radiographs, and 1-year weightbearing radiographs were reviewed. The following radiographic measurements were recorded: incongruency angle, talonavicular coverage angle (TNCA), talar-first metatarsal angle (T-1MT), and calcaneal pitch. Results: A total of 44 patients were included in our study. The mean age of the cohort was 54 (range, 18-74). The study cohort was divided into 2 groups. There were 17 (38.7%) patients who received a titanium metal wedge and 27 (61.5%) that received autograft or allograft. Patients that underwent LCL with the autograft/allograft group were significantly older (59 vs 47 years old, P = .006). Patients who underwent LCL with a titanium wedge had a significantly higher preoperative talonavicular angle (32 vs 27 degrees, P = .013). There were no significant differences in postoperative TNCA, incongruency angle, or calcaneal pitch at 6 months or 1 year. Conclusion: At 6 months and 1 year, no radiographic differences were found between autograft/allograft bone substitutes vs titanium wedge in LCL. Level of Evidence: Level III, retrospective cohort study.

CP110 and CEP135 localize near the proximal and distal centrioles of cattle and human spermatozoa.

Centrosomes play an important role in the microtubule organization of a cell. The sperm's specialized centrosome consists of the canonical barrel-shaped proximal centriole, the funnel-shaped distal centriole, and the pericentriolar material known as striated columns (or segmented columns). Here, we examined the localization of the centriole proteins CEP135 and CP110 in cattle and human spermatozoa. In canonical centrioles, CP110 is a centriole tip protein that controls cilia formation, while CEP135 is a structural protein essential for constructing the centriole. In contrast, we found antibodies recognizing CEP135 and CP110 label near the proximal and distal centrioles at the expected location of the striated columns and capitulum in cattle and humans in an antibody and species-specific way. These findings provide a pathway to understanding the unique functions of spermatozoan centrosome.

The admixed brushtail possum genome reveals invasion history in New Zealand and novel imprinted genes.

Combining genome assembly with population and functional genomics can provide valuable insights to development and evolution, as well as tools for species management. Here, we present a chromosome-level genome assembly of the common brushtail possum (Trichosurus vulpecula), a model marsupial threatened in parts of their native range in Australia, but also a major introduced pest in New Zealand. Functional genomics reveals post-natal activation of chemosensory and metabolic genes, reflecting unique adaptations to altricial birth and delayed weaning, a hallmark of marsupial development. Nuclear and mitochondrial analyses trace New Zealand possums to distinct Australian subspecies, which have subsequently hybridised. This admixture allowed phasing of parental alleles genome-wide, ultimately revealing at least four genes with imprinted, parent-specific expression not yet detected in other species (MLH1, EPM2AIP1, UBP1 and GPX7). We find that reprogramming of possum germline imprints, and the wider epigenome, is similar to eutherian mammals except onset occurs after birth. Together, this work is useful for genetic-based control and conservation of possums, and contributes to understanding of the evolution of novel mammalian epigenetic traits.

Judgment aggregation, discursive dilemma and reflective equilibrium: Neural language models as self-improving doxastic agents.

Neural language models (NLMs) are susceptible to producing inconsistent output. This paper proposes a new diagnosis as well as a novel remedy for NLMs' incoherence. We train NLMs on synthetic text corpora that are created by simulating text production in a society. For diagnostic purposes, we explicitly model the individual belief systems of artificial agents (authors) who produce corpus texts. NLMs, trained on those texts, can be shown to aggregate the judgments of individual authors during pre-training according to sentence-wise vote ratios (roughly, reporting frequencies), which inevitably leads to so-called discursive dilemmas: aggregate judgments are inconsistent even though all individual belief states are consistent. As a remedy for such inconsistencies, we develop a self-training procedure-inspired by the concept of reflective equilibrium-that effectively reduces the extent of logical incoherence in a model's belief system, corrects global mis-confidence, and eventually allows the model to settle on a new, epistemically superior belief state. Thus, social choice theory helps to understand why NLMs are prone to produce inconsistencies; epistemology suggests how to get rid of them.

We are who we thought we were: Confirming one's own antagonism levels.

Although many processes might contribute to the self-perpetuating nature of antagonistic personality, we proposed and tested the "antagonism-confirmation" perspective on this phenomenon. This perspective states that antagonistic personality is based in tendencies to confirm (vs. disconfirm) the self's beliefs about its personality. Importantly, this explanation uniquely predicts that antagonism-related personality constructs should relate to strategically adopting behaviors that vary on only their signification of higher or lower antagonism levels (and nothing more). In apparent privacy, nonclinical participants completed a color-gazing task, wherein antagonistic people ostensibly see colors become more (more-intense condition) or less intense (less-intense condition) while gazing at them. Consistent with the antagonism-confirmation perspective, antagonism-related personality constructs related to perceiving colors as turning more intense in the more-intense (vs. less-intense) condition. These effects could not be attributed to demand and occurred among a subsample of participants that indicated providing completely authentic responses. Furthermore, participants higher in antagonism-related personality constructs reported a greater likelihood of possessing antagonistic characteristics and that these characteristics were more beneficial; mediation evidence suggested that these reports were influenced by their confirmatory responding on the color-gazing task. Antagonism-confirmation tendencies might partly account for why antagonistic personality persists; broadly, the findings highlight the critical nature of identity management as a feature of antagonistic personality. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Revisiting the Interactive Effect of Narcissism and Self-Esteem on Responses to Ego Threat: Distinguishing Between Assertiveness and Intent to Harm.

We addressed whether narcissism and self-esteem synergize to enhance assertive responses and deter aggressive responses to ego-threatening provocation. Participants (N = 448) completed measures of narcissism and self-esteem, imagined ego-threatening provocation, and indicated their aggressive and assertive responses. Participants also completed individual difference measures of agreeableness, openness, status/dominance motivation, and endorsement of the notion that aggression begets power. Narcissism and self-esteem interacted to reduce aggressive responses but enhance assertive responses to ego-threat; moreover, this interaction related to enhanced agreeableness, openness, status/dominance motivation, and reduced endorsement of the belief that aggression begets power, and these relations accounted, in part, for relations between the interaction and aggressive and assertive responses. Broadly, the findings contribute to the contentious issue of how self-evaluation influences responses to ego-threat; specifically, we would suggest that this issue be conceptualized in terms of synergistic effects of narcissism and self-esteem and distinguish between assertive versus aggressive responding.

Provoked Narcissistic Aggression: Examining the Role of De-Escalated and Escalated Provocations.

Theories have postulated why provocation is particularly likely to incite aggression for narcissists, but key propositions from such theories dealing with psychological process or boundary conditions have seldom been tested. Here, we investigated narcissists' cognitive, emotional, and motivational experience and aggression following escalated and de-escalated provocation. Participants (N = 680) completed measures of grandiose narcissism (normal and pathological expressions) and vulnerable narcissism. Next, participants simulated provocation via imagining everyday scenarios in which a provocateur either de-escalates (apologizes and expresses concern) or escalates (makes a spiteful remark) the provocation and then rated anger and humiliation, perceived "narcissistic injury," goals, and aggression. Expressions of grandiose narcissism, but vulnerable narcissism, more strongly related to aggression following escalated (vs. de-escalated) provocation. Path modeling revealed that perceived narcissistic injury and narcissistic-identity goals explained this relation for pathological grandiose narcissists, and revenge goals and narcissistic-identity goals explained this relation for normal grandiose narcissists. Conversely, vulnerable narcissism related more strongly to anger, perceived narcissistic injury, and narcissistic-identity goals following de-escalated (vs. escalated) provocation. Path modeling revealed that vulnerable narcissists' enhanced anger-induced aggression is bounded to de-escalated provocation. We discuss the findings in relation to various theories of provoked narcissistic aggression.

An interaction model for the role of self-evaluations and antagonistic pursuits in subjective well-being.

Popular theorizing about happiness pursuit emphasizes universal paths to happiness, but other theorizing acknowledges different people achieve happiness in different ways (i.e., subjective well-being, SWB). The present work extended this latter perspective by examining how antagonistic pursuit of a grandiose identity ('narcissistic antagonism') - generally thought to reduce narcissistic people's SWB - may relate to increased cognitive well-being (i.e., a component of SWB) for narcissistic people with lower self-esteem. In Study 1, participants (N = 417) reported their narcissism, self-esteem, narcissistic antagonism, and general life satisfaction (to index cognitive well-being). In Study 2 (pre-registered), participants (N = 450) reported their narcissism, self-esteem, narcissistic antagonism, general and domain-specific life satisfaction, and general affect (to index affective well-being, which is a different component of SWB). Both studies revealed narcissistic antagonism related to increased life satisfaction only for more (vs. less) narcissistic people with lower (vs. higher) self-esteem. Study 2 not only replicated this interactive pattern on satisfaction across various life domains but also revealed the interaction may be related to increased negative affect. Broadly, results highlight how different people may enhance features of SWB in different, even 'dark', ways.

Impact of Exposure to Patient Death or Near Death on Compassion Fatigue in Pediatric Intensive Care Nurses.

BACKGROUND: Compassion fatigue affects up to 40% of health care professionals who work in intensive care settings. Frequent exposure to the death of patients, particularly children, may put nurses at risk for compassion fatigue, but the relation between these is unclear among those working in pediatric intensive care units. OBJECTIVES: To examine the relationship between exposure to the death or near death of a pediatric patient and compassion fatigue, specifically the outcomes of compassion satisfaction, burnout, and secondary traumatic stress. METHODS: Pediatric and neonatal intensive care nurses were surveyed about their exposure to patient death and near-death experiences. They were asked to respond to the Professional Quality of Life Scale, which has 3 subscales that measure compassion satisfaction, burnout, and secondary traumatic stress. Bivariate and multivariate linear regression modeling was used to identify correlates of these outcomes. RESULTS: Of the 65 respondents, 94% were female, 41% were aged 31 to 45 years, and 71% had a bachelor's degree. No significant relationship was found between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Significant correlates of compassion satisfaction and burnout included educational level and an age-experience interaction. CONCLUSIONS: No relationship seems to exist between nurses' experiences of patient death or near death and their compassion satisfaction, burnout, or secondary traumatic stress. Further research is needed to evaluate the impact of educational attainment on nurse outcomes and determine how best to support nurses who are at risk for compassion fatigue.

'You Are What You Read:' Is selective exposure a way people tell us who they are?

Selective exposure is the tendency to gather viewpoint-congenial versus viewpoint-uncongenial information. Extant models of selective exposure suggest this tendency occurs because people anticipate reading congenial (vs. uncongenial) information will cause more favourable intrapersonal consequences. However, these models ignore the notion that people's information choices are, in part, symbolic gestures designed to convey identity-relevant beliefs to an audience through information display. Drawing from perspectives that emphasize human consumption as symbolic and a way to signal one's identity, we suggest that selective exposure pertains not only to information processing but also to conveying identity through information display. Experiment 1 showed that people characterize information display as a way to communicate their views to an audience. Experiments 2-4 showed that people are averse to displaying uncongenial versus congenial information (without processing the information), anticipate feeling more uncomfortable and more inauthentic merely displaying (without processing) uncongenial versus congenial information, and that people's intentions to engage in selective exposure in daily life are a function of their belief that selective-exposure displays convey their identity. None of these studies or findings can be generated from extant selective-exposure theories. Thus, selective-exposure theories are likely incomplete because they ignore people's beliefs and goals regarding information display.

Validating Circumplex Scales of Perceived Impairments and Benefits from prototypically problematic interpersonal tendencies.

Clinical and personality research and theorizing has benefitted from assessing people's experiences of interpersonal problems, but these assessments have neglected assessing people's subjective perceptions of impairments and benefits from such problems. To address this gap, 2 studies tested the reliability and validity of 2 interpersonal circumplex-based measures of subjectively perceived impairments ("Circumplex Scales of Interpersonal Problems-Impairments" or "CSIP-Impairments") and benefits ("CSIP-Benefits") from prototypically problematic interpersonal tendencies. Study 1 (N = 291) found evidence supporting the internal consistencies and circumplex structures of both CSIP-Impairments and CSIP-Benefits, and it compared their structures to other IPC-based measures; Study 2 (N = 564) replicated support for these internal consistencies and circumplex structures and provided construct validity evidence for CSIP-Impairments and CSIP-Benefits by relating them to dark personalities and personality disorder traits. CSIP-Impairments and CSIP-Benefits may aid researchers and clinicians in further understanding and developing therapy strategies for treating problematic interpersonal tendencies. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Cannabinoid Use in Musculoskeletal Illness: a Review of the Current Evidence.

PURPOSE OF REVIEW: The use of cannabinoids has increased since legalization of recreational and medical use in the USA. It is likely that many orthopaedic patients consume cannabinoid products during the traumatic or perioperative period. The purpose of this study was to investigate the pre-clinical data evaluating the mechanism of action of cannabidiol (CBD) and Δ9-Tetrahydrocannabinol (Δ9-THC) and to evaluate the current clinical data on the use of cannabinoids in musculoskeletal illness. RECENT FINDINGS: Recent pre-clinical studies have demonstrated that cannabinoid use and the endocannabinoid system (ECS) has an important role in bone healing and bone homeostasis. There is data that suggests that the use of cannabidiol (CBD) may increase bone healing, whereas the use of Δ9-Tetrahydrocannabinol (Δ9-THC), the major psychoactive ingredient in marijuana, likely inhibits bone metabolism and repair. The clinical implications and consumption of marijuana by orthopaedic patients have not been thoroughly evaluated. Studies have demonstrated concern for negative cardiovascular and psychiatric effects caused by marijuana use, but have not yet elucidated outcomes in the orthopaedic literature. With the recent increase in advertising of CBD products and legalization of marijuana, it is likely that many orthopaedic patients are consuming cannabinoid products. The clinical implications and consumption of these products are unclear. We need more robust and well-designed clinical studies prior to making further recommendations to our patients on the consumption of these products.