Self-Efficacy and Hemoglobin A1C Among Adults With Serious Mental Illness and Type 2 Diabetes: The Roles of Cognitive Functioning and Psychiatric Symptom Severity.

BACKGROUND: Self-efficacy is a core element of diabetes self-care and a primary target of diabetes interventions. Adults with serious mental illness (SMI) are twice as likely as adults among the general population to have Type 2 diabetes. This population faces substantial barriers (i.e., cognitive impairment, psychiatric symptoms) to optimal diabetes self-care, but the relationship of these barriers to both self-efficacy and glycemic control (hemoglobin A1C [A1C]) is not clearly understood. METHODS: Data collected from adult participants with SMI (i.e., schizophrenia, schizoaffective disorder, bipolar disorder) and Type 2 diabetes (n = 92) were used to examine the moderating effects of cognitive functioning and psychiatric symptoms (i.e., positive and negative symptoms) on the association between self-efficacy and A1C. RESULTS: The relationship between self-efficacy and A1C was moderated by cognitive functioning (B = -4.03, standard error = 1.54, p = .011). Greater self-efficacy was associated with better glycemic control when cognitive functioning was high, but worse control when functioning was low. The relationship between self-efficacy and A1C was moderated by negative symptom severity (B = 6.88, standard error = 3.34, p = .043). Higher self-efficacy was associated with poorer glycemic control only when negative symptom severity was high. Positive symptoms did not interact with self-efficacy to predict A1C. CONCLUSIONS: These results suggest that adults with SMI and low cognitive function or high negative symptom severity may misperceive their ability to manage their diabetes. They may benefit from efforts, including care management and monitoring, cognitive remediation, and skill training, to identify and correct inaccurate diabetes self-efficacy.

Mindfulness during romantic conflict moderates the impact of negative partner behaviors on cortisol responses.

This study was designed to test whether romantic partners' mindfulness-present moment, nonjudgmental awareness-during a conflict discussion could buffer the effects of negative partner behaviors on neuroendocrine stress responses. Heterosexual couples (n=88 dyads) provided 5 saliva samples for cortisol assay during a laboratory session involving a conflict discussion task. Conflict behaviors were coded by outside observers using the System for Coding Interactions in Dyads, and partners rated their mindfulness during the task using the Toronto Mindfulness Scale. Interactions tested using multilevel modeling revealed that participants with higher levels of mindfulness during the conflict showed either quicker cortisol recovery or an absence of slowed recovery in the presence of more negative partner behaviors. Whereas the attitudinal component of mindfulness (curiosity) moderated effects of negative partner engagement in the conflict (i.e., attempts to control, coerciveness, negativity and conflict), the attentional component of mindfulness (decentering) moderated the effect of partner disengagement (i.e., withdrawal). These findings lend support to the idea that mindfulness during a stressful interaction can mitigate the physiological impacts of negative behaviors.

Unintended, but still blameworthy: the roles of awareness, desire, and anger in negligence, restitution, and punishment.

Two experiments (Experiment 1 N = 149, Experiment 2 N = 141) investigated how two mental states that underlie how perceivers reason about intentional action (awareness of action and desire for an outcome) influence blame and punishment for unintended (i.e., negligent) harms, and the role of anger in this process. Specifically, this research explores how the presence of awareness (of risk in acting, or simply of acting) and/or desire in an acting agent's mental states influences perceptions of negligence, judgements that the acting agent owes restitution to a victim, and the desire to punish the agent, mediated by anger. In both experiments, awareness and desire led to increased anger at the agent and increased perception of negligence. Anger mediated the effect of awareness and desire on negligence rather than negligence mediating the effect of mental states on anger. Anger also mediated punishment, and negligence mediated the effects of anger on restitution. We discuss how perceivers consider mental states such as awareness, desire, and knowledge when reasoning about blame and punishment for unintended harms, and the role of anger in this process.

Genetic attributions and mental illness diagnosis: effects on perceptions of danger, social distance, and real helping decisions.

UNLABELLED: Genetic essentialism suggests that beliefs in genetic causes of mental illness will inflate a desire for social distance from affected individuals, regardless of specific disorder. However, genetic contingency theory predicts that genetic attributions will lead to an increased desire for social distance only from persons with disorders who are perceived as dangerous. PURPOSE: To assess the interactive effect of diagnosis and attribution on social distance and actual helping decisions across disorders. METHODS: Undergraduate students (n = 149) were randomly assigned to read one of the six vignettes depicting a person affected by one of the three disorders (i.e., schizophrenia, bipolar disorder, or major depression) with either a genetic or environmental causal attribution for disorder. Participants completed measures of perceived dangerousness, social distance, empathic concern, familiarity with mental illness, and actual helping decisions. RESULTS: When provided with genetic attributions, participants' desire for social distance was greater for targets with schizophrenia relative to targets with depression or bipolar disorder. This effect was mediated by perceived dangerousness. The indirect effect of diagnosis on helping decisions, through social distance, was significant within the genetic attribution condition. CONCLUSION: Consistent with genetic contingency theory, genetic attributions for schizophrenia, but not affective disorders, lead to greater desire for social distance via greater perceived dangerousness. Further, results suggest that genetic attributions decrease the likelihood of helping people with schizophrenia, but have no effect on the likelihood of helping people with affective disorders. These effects are partially accounted for by desired social distance from people with schizophrenia.

Punishing hypocrisy: the roles of hypocrisy and moral emotions in deciding culpability and punishment of criminal and civil moral transgressors.

Three experiments explored how hypocrisy affects attributions of criminal guilt and the desire to punish hypocritical criminals. Study 1 established that via perceived hypocrisy, a hypocritical criminal was seen as more culpable and was punished more than a non-hypocritical criminal who committed an identical crime. Study 2 expanded on this, showing that negative moral emotions (anger and disgust) mediated the relationships between perceived hypocrisy, criminal guilt, and punishment. Study 3 replicated the emotion finding from Study 2 using new scenarios where group agents were clearly aware of the hypocrisy of their actions, yet acted anyway. Again, perceived hypocrisy worked through moral emotions to affect criminal guilt and punishment. The current studies provide empirical support for theories relating hypocrisy and moral transgressions to moral emotions, also informing the literature on the role of moral emotions in moral reasoning and legal decision making.

People who seem disgusting seem more immoral.

Despite unresolved questions about replicability, a substantial number of studies find that disgust influences and arises from evaluations of immoral behavior and people. Departing from prior emphases, the current research examines a novel, related question: Are people who are viewed as disgusting (i.e., people whose habits seem disgusting) perceived as more immoral than typical or unusual people? Four experiments examined this, also exploring the downstream impacts of moral character judgments. Adults who seemed disgusting were regarded as more immoral for purity and non-purity violations (Experiment 1) and less praiseworthy for prosocial acts (Experiment 2). In Experiment 3, an 8-year-old with typical (but seemingly disgusting) habits was rated as "naughtier" and likelier to misbehave than an atypical child who loved vegetables and disliked sweets. Experiment 4 revealed how, when no behavioral information is available, beliefs about target disgust influence beliefs about future behavior, helping explain why seemingly disgusting targets are viewed as more immoral, but not always more punishable for their bad behavior.

Interdependent versus independent inconsistency: Cultural differences in how East Asian and Western people attribute hypocrisy.

Humans worldwide have long deplored hypocrisy, a concept that has been mentioned in texts dating back 100-1,000 years (e.g., the Analects of Confucius, the Tao Te Ching, the Bible, and the Qur'an). However, what influences the extent of hypocrisy attribution or counts as hypocrisy may differ as a function of culture. Previous studies have shown that Westerners attribute greater hypocrisy for within-person attitude-behavior inconsistency than East Asians. Building on this, we predict that East Asians' (vs. Westerners') hypocrisy attribution is more heavily influenced by social relationships. Consistent with past research, this can lead to greater leniency. However, as we show, this can also result in the novel finding we present that attributions of mild-to-moderate hypocrisy are made even when no explicit within-person attitude-behavior inconsistency is present. Across six experiments, we found that Koreans (vs. participants from the United States) attributed more hypocrisy to attitude-contradicting behavior when the person enacting the behavior was not the person who stated the attitude but was someone who shared social bonds with that person (i.e., cross-person, within-relationship attitude-behavior inconsistency; "relational hypocrisy"). Specifically, Koreans attributed more hypocrisy than Americans when a child's behavior contradicted their parent's views (Experiments 1a and 1b) or when attitude-contradicting behavior was enacted by the child of a close friend (Experiment 2). Experiments 3-5 replicated the findings from Experiments 1-2 using additional social contexts (e.g., a spousal relationship). Supplementary analyses showed that differences in hypocrisy attribution between Americans and Koreans were mediated by cultural differences in their perceptions of shared responsibility within relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Salivary nerve growth factor reactivity to acute psychosocial stress: a new frontier for stress research.

OBJECTIVE: Neurotrophins such as nerve growth factor (NGF) may represent a stress-responsive system complementing the better known neuroendocrine (hypothalamic-pituitary-adrenal axis) and autonomic nervous system, but there is little evidence for NGF response to acute stress in humans because noninvasive measures have not been available. We investigated salivary NGF (sNGF) in 40 healthy young adults confronting a romantic conflict stressor. METHODS: Five saliva samples-two collected before and three after the conflict-were assayed for sNGF, cortisol (hypothalamic-pituitary-adrenal marker), and α-amylase (sAA; ANS marker). In addition, a control group (n = 20) gave saliva samples at the same time intervals to determine whether sNGF changes were specific to the conflict stressor. RESULTS: sNGF showed significant reactivity from entry to the first poststress sample among study participants (ß = .13, p = .001), with nonsignificant change across poststress samples. Control participants showed no change in sNGF across the same period. Within-person changes in sNGF were generally aligned with both cortisol (ß = .17, p = .003) and sAA (ß = .17, p = .021) responses. Preconflict negative emotion predicted lower sNGF reactivity (ß = -.08, p = .009) and less alignment with sAA (ß = -.09, p = .040), whereas positive emotion predicted less alignment with cortisol (ß = -.10, p = .019). CONCLUSIONS: This study is the first to document sNGF as a marker that responds to stress in humans.

Beautiful seems good, but perhaps not in every way: Linking attractiveness to moral evaluation through perceived vanity.

For almost 50 years, psychologists have understood that what is beautiful is perceived as good. This simple and intuitively appealing hypothesis has been confirmed in many ways, prompting a wide range of studies documenting the depth and breadth of its truth. Yet, for what is arguably one of the most important forms of "goodness" that there is-moral goodness-research has told a different story. Although greater attractiveness is associated with a host of positive attributes, it has been only inconsistently associated with greater perceived morality (or lesser immorality), and meta-analyses have suggested the total effect of beauty on moral judgment is near zero. The current research documents one plausible reason for this. Across nine experiments employing a variety of methodological and measurement strategies, we show how attractiveness can be perceived as both morally good and bad. We found that attractiveness causally influences beliefs about vanity, which translates into beliefs that more attractive targets are less moral and more immoral. Then, we document a positive association between attractiveness and sociability-the nonmoral component of warmth-and show how sociability exerts a countervailing positive effect on moral judgments. Likewise, we document findings suggesting that vanity and sociability mutually suppress the effects of attractiveness on each other and on moral judgments. Ultimately, this work provides a comprehensive process account of why beauty seems good but can also be perceived as less moral and more immoral, highlighting complex interrelations among different elements of person perception. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

No one is an island: Awe encourages global citizenship identification.

Recent theorizing has suggested that awe is a collective emotion, as research has demonstrated a clear link between experiencing awe and behaving prosocially. The present research extends past work by investigating the scope and sources of awe-inspired prosociality, focusing on whether awe's effects extend beyond local/national interests to include global or humanitarian goals. Specifically, we examine how by increasing feelings of smallness, awe encourages a sense of global citizenship, promoting cosmopolitan (vs. parochial) prosociality. Four experiments found that varied awe elicitors (recall, pictures, videos) and cues (universe, peaceful/fearful nature scenes) boost global citizenship identification by first increasing perception of the self as small. Downstream effects included greater valuing of interconnectedness (Experiment 2) and higher appreciation of diversity (Experiment 3). In Experiment 4, awe-through small self- and global citizenship-further translated into larger donation allocations to global (vs. local) charities. Given global problems such as pandemics and climate change, our findings have implications for how emotions can promote a sense of shared responsibility when commitment across borders is essential. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reading between the minds: the use of stereotypes in empathic accuracy.

An ideal empathizer may attend to another person's behavior in order to understand that person, but it is also possible that accurately understanding other people involves top-down strategies. We hypothesized that perceivers draw on stereotypes to infer other people's thoughts and that stereotype use increases perceivers' accuracy. In this study, perceivers (N = 161) inferred the thoughts of multiple targets. Inferences consistent with stereotypes for the targets' group (new mothers) more accurately captured targets' thoughts, particularly when actual thought content was also stereotypic. We also decomposed variance in empathic accuracy into thought, target, and perceiver variance. Although past research has frequently focused on variance between perceivers or targets (which assumes individual differences in the ability to understand other people or be understood, respectively), the current study showed that the most substantial variance was found within targets because of differences among thoughts.

Volition Speaks Louder Than Action: Offender Atonement, Forgivability, and Victim Valuation in the Minds of Perceivers.

On hearing of others' offenses, people frequently intervene to encourage offenders to correct their wrongs. However, externally imposed reconciliatory behaviors may not effectively convince outside observers that offenders value victims' welfare and deserve forgiveness. Four studies examined meta-judgments of victim valuation and offender forgivability when restitution was initiated voluntarily versus externally coerced. The same compensatory actions produced greater perceived valuation/forgivability when atonement was voluntary versus court-ordered (Experiment 1). Across multiple harm/measure types, voluntary (vs. imposed) atonement consistently yielded greater valuation/forgivability, but differences between imposed and no-atonement conditions were not captured using indirect valuation measures (Experiments 2-3). Experiment 3 also showed that voluntary (vs. imposed) atonement positively influenced perceivers' inferences about their own valuation. In Experiment 4, observers perceived greater valuation/forgivability when restitution was made voluntarily rather than imposed by an intervener or requested by the victim. These studies highlight that beyond their compensatory acts, offenders' volition to atone influences third-party evaluations.

The (income-adjusted) price of good behavior: Documenting the counter-intuitive, wealth-based moral judgment gap.

Poor people are punished more frequently and more severely than are wealthy people for their transgressions, suggesting that an agent's wealth affects how they are morally evaluated. To our knowledge, this has not been tested empirically. An initial study found that people expect the poor to be judged more harshly than the wealthy. Several other experiments consistently found that the reverse was true: Poor targets were judged as less immoral than wealthy targets for the same moral violations. Explanations of this wealth-based moral judgment gap were explored, including differences in descriptive/prescriptive expectations, global anti-wealthy or pro-poor biases, and differences in how people understand and explain the behavior of wealthy and poor moral transgressors. Although the moral judgment gap is likely multiply determined, poor targets were consistently viewed as having better reasons than the wealthy to act badly. Thus, the immoral behavior of poor targets was attributed to situational factors and was discounted, whereas wealthy targets' behavior was perceived as less excusable and was attributed primarily to bad moral character. A final study extended our findings to the domain of prosocial behavior. Consistent with a reasons-based explanation, poor targets were viewed as having better moral character than wealthy targets when their behavior benefitted others, and wealthy targets were viewed as having more extrinsic reasons to behave prosocially. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychological predictors of vaccination intentions among U.S. undergraduates and online panel workers during the 2020 COVID-19 pandemic.

OBJECTIVE: Availability of safe and effective vaccines against COVID-19 is critical for controlling the pandemic, but herd immunity can only be achieved with high vaccination coverage. The present research examined psychological factors associated with intentions to receive COVID-19 vaccination and whether reluctance towards novel pandemic vaccines are similar to vaccine hesitancy captured by a hypothetical measure used in previous research. METHOD: Study 1 was administered to undergraduate students when COVID-19 was spreading exponentially (February-April 2020). Study 2 was conducted with online panel workers toward the end of the first U.S. wave (July 2020) as a pre-registered replication and extension of Study 1. In both studies, participants (total N = 1,022) rated their willingness to receive the COVID-19 vaccination and to vaccinate a hypothetical child for a fictitious disease, and then responded to various psychological measures. RESULTS: In both studies, vaccination intentions were positively associated with past flu vaccine uptake, self-reported vaccine knowledge, vaccine confidence, and sense of collective responsibility. Complacency (not perceiving disease as high-risk), anti-vaccine conspiracy beliefs, perceived vaccine danger, and mistrust in science/scientists were negative correlates of vaccination intentions. Constraints (psychological barriers), calculation (extensive information-searching), analytical thinking, perceived disease vulnerability, self-other overlap, and conservatism were weakly associated with vaccination intentions but not consistently across both studies or vaccine types. Additionally, similar factors were associated with both real and hypothetical vaccination intentions, suggesting that conclusions from pre-COVID vaccine hesitancy research mostly generalize to the current pandemic situation. CONCLUSION: Encouraging flu vaccine uptake, enhancing confidence in a novel vaccine, and fostering a sense of collective responsibility are particularly important as they uniquely predict COVID-19 vaccination intentions. By including both actual pandemic-related hesitancy measures and hypothetical hesitancy measures from past research in the same study, this work provides key context for the generalizability of earlier non-pandemic research.

Understanding Side-Effect Intentionality Asymmetries: Meaning, Morality, or Attitudes and Defaults?

People frequently label harmful (but not helpful) side effects as intentional. One proposed explanation for this asymmetry is that moral considerations fundamentally affect how people think about and apply the concept of intentional action. We propose something else: People interpret the meaning of questions about intentionally harming versus helping in fundamentally different ways. Four experiments substantially support this hypothesis. When presented with helpful (but not harmful) side effects, people interpret questions concerning intentional helping as literally asking whether helping is the agents' intentional action or believe questions are asking about why agents acted. Presented with harmful (but not helpful) side effects, people interpret the question as asking whether agents intentionally acted, knowing this would lead to harm. Differences in participants' definitions consistently helped to explain intentionality responses. These findings cast doubt on whether side-effect intentionality asymmetries are informative regarding people's core understanding and application of the concept of intentional action.

The effect of admitting fault versus shifting blame on expectations for others to do the same.

A wealth of research has investigated how and why people cast blame. However, less is known about blame-shifting (i.e., blaming someone else for one's own failures) and how exposure to a blame-shifting agent might lead to expectations that other agents will also shift blame. The present research tested whether exposure to a blame-shifting (versus responsibility-taking) agent would lead perceivers to expect a second, unrelated target to also shift blame. Contrary to our expectations, people expected greater blame-shifting after exposure to a responsible agent, particularly when perceivers were surprised by this reaction to failure. Discussion focuses on how people habitually expect some people to shift blame for their mishaps, and how expectancy violations when people act in unexpected ways predict the extent to which perceivers expect unrelated agents to also shift blame.

Reconstructing the side-effect effect: A new way of understanding how moral considerations drive intentionality asymmetries.

People typically apply the concept of intentionality to actions directed at achieving desired outcomes. For example, a businessperson might intentionally start a program aimed at increasing company profits. However, if starting the program leads to a foreknown and harmful side effect (e.g., to the environment), the side effect is frequently labeled as intentional even though it was not specifically intended or desired. In contrast, positive side effects (e.g., helping the environment) are rarely labeled as intentional. One explanation of this side-effect effect-that harmful (but not helpful) side effects are labeled as intentional-is that moral considerations influence whether people view actions as intentional or not, implying that bad outcomes are perceived as more intentional than good outcomes. The present research, however, shows that people redefine questions about intentionality to focus on agents' foreknowledge in harming cases and on their lack of desire or intention in helpful cases, suggesting that the same intentionality question is being interpreted differently as a function of side effect valence. Consistent with this, removing foreknowledge lowers the frequency of labeling harming as intentional without affecting whether people label helping as intentional. Likewise, increasing agents' desire to help or avoid harming increases rates of labeling helping as intentional without affecting rates of labeling harming as intentional. In summary, divergent decisions to label side effects as intentional or not appear to reflect differences in the criteria people use to evaluate each case, resulting in different interpretations of what questions about intentionality are asking. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Why side-effect outcomes do not affect intuitions about intentional actions: properly shifting the focus from intentional outcomes back to intentional actions.

Over the last decade, many articles have suggested that the "badness" of side-effect outcomes influences perceivers' intuitions about intentionality, contradicting the traditional notion that mental state inferences lead to moral judgments rather than the reverse. Challenging this assertion, we argue that typically, consideration of intentionality involves thinking about "intentional actions" (things people do) rather than unintended outcomes. Across several studies, we offer an explanatory framework describing why side-effect asymmetries emerge. We first establish that people differentiate actions, outcomes, goals, and side effects, associating intentions with goals but intentionality with actions in furtherance of goals, and that each of these components is readily identified in side-effect scenarios. We then demonstrate that when relationships among actions, goals, and side effects are available for consideration in response options, side-effect effects disappear. We additionally show that, because actions are not explicitly referenced, people reinterpret questions about the intentionality of side effects-particularly for harmful outcomes-as asking about intentional actions that caused side effects, creating a mismatch between participants' pragmatic and researchers' literal interpretations. Finally, we demonstrate how harmful side effects shift perceivers' attention toward considering agents' knowledge/awareness, whereas beneficial side effects focus attention on intentions/motives, which serves a useful social purpose. We discuss how perceptions of intentionality are not influenced by side-effect valence, although, because of structural differences in how people view harm versus benefit, outcomes influence which mental states perceivers consider important when answering questions that are typically asked in side-effects research. Beyond intentionality, we consider how these findings may shed light on trait attribution processes, more generally.

Salivary nerve growth factor response to stress related to resilience.

Salivary nerve growth factor (sNGF) has recently been shown to respond to psychosocial stress, but little is known about how individual differences in this neurotrophic marker relate to stress vulnerability vs. resilience. This study followed up on these initial findings by examining sNGF responses to interpersonal stress in relation to both well-being and state/trait factors that determine the way a person approaches and is impacted by stress. Young adults (n=40) gave 5 saliva samples over the course of a laboratory session that involved an interpersonal conflict stressor, and all samples were assayed for sNGF. Participants also completed self-report measures of global well-being, stress appraisals before and following the conflict, and agency. Greater sNGF reactivity to conflict related to stronger appraisals of coping ability and agency. Post-conflict sNGF recovery related to lower anticipatory stress appraisals, and to higher agency and well-being. These results support the idea that dynamic sNGF responses are adaptive. Implications for the potential role of the neurotrophic system in stress resilience are discussed.

Sexual dysfunction in depression and anxiety: conceptualizing sexual dysfunction as part of an internalizing dimension.

Sexual dysfunction is often implicated in depression and anxiety disorders, but the current nosology of sexual dysfunction, depression, and anxiety (i.e., DSM-IV) does not adequately address these relationships. Because recent papers (Krueger, R. F., & Markon, K. E. (2006). Reinterpreting comorbidity: A model-based approach to understanding and classifying psychopathology. Annual Review of Clinical Psychology, 2, 111-133) have suggested and provided evidence for latent internalizing and externalizing dimensions that help explain high comorbidity between mental disorders, the current paper suggests that sexual dysfunction might conceptually belong to a latent internalizing factor. To address this, evidence is presented for the relationship among disorders of sexual desire, arousal, and orgasm comorbid with depression and anxiety. A review of sexual disorders is also presented along with a critical examination of the way the current DSM is organized with respect to sexual dysfunction, depression, and anxiety.