Cultural humility and racial microaggressions in cross-racial clinical supervision: A moderated mediation model.

Cultural humility is important in supervision; however, studies have primarily sampled White supervisees. Racially and ethnically minoritized trainees experience microaggressions during their training, yet cross-racial supervision is less often studied. We examined a moderated mediation model to test whether the supervisory working alliance mediated the relationship between frequency of racial microaggressions and satisfaction with supervision, and whether the impact of racial microaggressions on the supervisee and supervisor cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance. In a sample of supervisees of color (N = 102; majority cisgender women, 86.2%, and heterosexual, 59.8%; 35.3% Black/African American, 28.4% Asian/Pacific Islander, 18.6% Hispanic/Latine) receiving clinical supervision from White supervisors, we found that racial microaggression frequency was negatively associated with satisfaction with supervision, and this relationship was fully accounted for by the supervisory working alliance. Racial microaggressions in supervision were found to be detrimental to the supervisory working alliance, which was then related to lower satisfaction with supervision. Further, racial microaggression impact and cultural humility moderated the relationship between racial microaggression frequency and the supervisory working alliance; this relationship was strongest when racial microaggression impact was high and cultural humility was average or high. The social bond hypothesis suggests we are more likely to allow ourselves to be vulnerable when we assess cultural humility to be high. We posit that the observed moderation effect may be due to supervisees experiencing greater shock when experiencing racial microaggressions from supervisors whom they perceived to be culturally humble. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Even Shorter Almost Perfect Scale: Psychometric Evaluation and Cross-National Implications for Psychological Outcomes.

Short empirically-supported scales or individual items are preferred in comprehensive surveys, brief screeners, and experience sampling studies. To that end, we examined the Short Almost Perfect Scale (SAPS) to evaluate empirical support for the interchangeability of items to measure perfectionistic strivings (Standards) and perfectionistic concerns (Discrepancy). Based on a large and diverse sample (N = 1,103) and tests of tau-equivalence (equal factor loadings) for each respective set of items, Study 1 advanced a subset of SAPS items to measure Standards (2 items) and Discrepancy (3 items). Cross-sectional gender and race/ethnicity invariance were supported, and in structural equations analyses, the SAPS5 factors were significantly associated with depression, state anxiety, life satisfaction, and gratitude. Study 2 cross-validated Study 1 measurement and structural findings with a new U.S. sample (N = 803). The three items representing the Discrepancy (perfectionistic concerns) factor also were supported in a cross-national comparison between the U.S. sample and a scale development sample in New Zealand (N = 3,921). For the most part, across both studies and all analyses, the three Discrepancy items were empirically interchangeable indicators of perfectionistic concerns and comparably strong predictors of psychological outcomes, supporting their use in studies or other contexts with space or time restrictions for measurement.

Meta-analysis of the relationship between self-critical perfectionism and depressive symptoms: Comparison between Asian American and Asian international college students.

A body of research has been dedicated to demonstrating the relationship of perfectionism with a range of mental health indicators. Self-critical perfectionism, a component of perfectionism, has been framed primarily in a negative light within the mental health context. Given that research informs educational and clinical practices, it is important to explore the degree to which such findings generalize across cultures and subcultures. The current meta-analytic research systemically collated studies conducted with Asian college students with a particular attention to exploring whether orientation to Asian culture and cultural values correspondingly moderates the relationship between self-critical perfectionism and depressive symptoms. The degree of upholding Asian cultural values was represented by group identity (i.e., Asian American and Asian international). Eleven studies (N = 3,239) were identified through the literature search. Findings from the random-effects meta-analysis indicated a significant relationship between self-critical perfectionism and depressive symptoms in the overall sample. The group identity significantly moderated the relationship; among Asian international college students, self-critical perfectionism appeared to have a less harmful effect on mental distress compared to Asian American college students. Self-cultivation-one of the salient and virtuous Asian cultural values that aligns with self-critical perfectionism-may have motivated continuous striving for self-improvement to fulfill the honorable duty for their family for Asian international students. Additional findings and implications of the study are further discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Resource loss and mental health during COVID-19: Psychosocial protective factors among U.S. older adults and those with chronic disease.

Across the globe, COVID-19 has disproportionately affected the physical and mental health of several vulnerable groups. In a series of two cross-sectional studies conducted April to July 2020, we examined its acute mental health effects on two vulnerable U.S. community samples-home-bound older adults who were at or below the poverty line (Study 1, N = 293, Mage  = 76.94, SD = 8.64; 75.1% female, 67.9% Black) and adults with chronic disease (Study 2, N = 322, Mage  = 62.20, SD = 12.22; 46.3% female, 28.3% racial/ethnic minorities). Based on the conservation of resources theory, we hypothesised that pandemic-related resource loss would be associated with greater mental distress, but perceived social support and positive psychological characteristics (trait resilience and optimism) would buffer against this adverse effect. Across both samples of vulnerable adults, pandemic-related resource loss was related to mental distress. Perceived social support was related to lower mental distress but did not consistently buffer the effect of resource loss on mental health. However, in Study 2, both trait resilience and optimism buffered this relationship. Findings are discussed in terms of their implications for the conservation of resources theory.

Targeted and Untargeted Mass Spectrometry Reveals the Impact of High-Fat Diet on Peripheral Amino Acid Regulation in a Mouse Model of Alzheimer's Disease.

Recent research regarding amino acid metabolism has shown that there may be a link between obesity and Alzheimer's disease (AD). This work reports a metabolomics study using targeted and untargeted mass spectrometry-based metabolomic strategies to investigate this link. Targeted hydrophilic interaction liquid chromatography-triple quadrupole mass spectrometry and untargeted reversed-phase liquid chromatography-high resolution tandem mass spectrometry assays were developed to analyze the metabolic changes that occur in AD and obesity. APPSwe/PS1ΔE9 (APP/PSEN1) transgenic mice (to represent familial or early-onset AD) and wild-type littermate controls were fed either a high-fat diet (HFD, 60% kcal from lard) or a low-fat diet (LFD, 10% kcal from lard) from 2 months of age or a reversal diet (HFD, followed by LFD from 9.5 months). For targeted analyses, we applied the guidelines outlined in the Clinical and Laboratory Standards Institute (CLSI) LC-MS C62-A document and the U.S. Food and Drug Administration (FDA) bioanalytical method validation guidance for industry to evaluate the figures of merit of the assays. Our targeted and untargeted metabolomics results suggest that numerous peripheral pathways, specifically amino acid metabolism and fatty acid metabolism, were significantly affected by AD and diet. Multiple amino acids (including alanine, glutamic acid, leucine, isoleucine, and phenylalanine), carnitines, and members of the fatty acid oxidation pathway were significantly increased in APP/PSEN1 mice on HFD compared to those on LFD. More substantial effects and changes were observed in the APP/PSEN1 mice than in the WT mice, suggesting that they were more sensitive to an HFD. These dysregulated peripheral pathways include numerous amino acid pathways and fatty acid beta oxidation and suggest that obesity combined with AD further enhances cognitive impairment, possibly through aggravated mitochondrial dysfunction. Furthermore, partial reversibility of many altered pathways was observed, which highlights that diet change can mitigate the metabolic effects of AD. The same trends in individual amino acids were observed in both strategies, highlighting the biological validity of the results.

Multidimensional Separations of Intact Phase II Steroid Metabolites Utilizing LC-Ion Mobility-HRMS.

The detection and unambiguous identification of anabolic-androgenic steroid metabolites are essential in clinical, forensic, and antidoping analyses. Recently, sulfate phase II steroid metabolites have received increased attention in steroid metabolism and drug testing. In large part, this is because phase II steroid metabolites are excreted for an extended time, making them a potential long-term chemical marker of choice for tracking steroid misuse in sports. Comprehensive analytical methods, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS), have been used to detect and identify glucuronide and sulfate steroids in human urine with high sensitivity and reliability. However, LC-MS/MS identification strategies can be hindered by the fact that phase II steroid metabolites generate nonselective ion fragments across the different metabolite markers, limiting the confidence in metabolite identifications that rely on exact mass measurement and MS/MS information. Additionally, liquid chromatography-high-resolution mass spectrometry (LC-HRMS) is sometimes insufficient at fully resolving the analyte peaks from the sample matrix (commonly urine) chemical noise, further complicating accurate identification efforts. Therefore, we developed a liquid chromatography-ion mobility-high resolution mass spectrometry (LC-IM-HRMS) method to increase the peak capacity and utilize the IM-derived collision cross section (CCS) values as an additional molecular descriptor for increased selectivity and to improve identifications of intact steroid analyses at low concentrations.

Perceived and actual posttraumatic growth in religiousness and spirituality following disasters.

OBJECTIVE: Religious/spiritual (R/S) growth is a core domain of posttraumatic growth (PTG). However, research on R/S growth following disasters has over-relied on retrospective self-reports of growth. We therefore examined longitudinal change in religiousness/spirituality following two disasters. METHOD: Religious survivors of Hurricanes Harvey (Study 1) and Irma (Study 2) completed measures of perceived R/S PTG, general religiousness/spirituality ("current standing"-R/S PTG), and subfacets of religiousness/spirituality (spiritual fortitude, religious motivations, and benevolent theodicies). In Study 1, 451 participants responded at 1-month and 2-month postdisaster. In Study 2, participants responded within 5-days predisaster and at 1-month (N = 1,144) and 6-months postdisaster (N = 684). RESULTS: In both studies, perceived R/S PTG was weakly related to longitudinal increases in general religiousness/spirituality and in most of its subfacets, but reliable growth in any R/S outcome was rare. Additionally, Study 2 revealed evidence that actual change in psychological well-being is associated with actual (but not perceived) R/S PTG, but disaster survivors tend to exhibit declines in their religiousness/spirituality, spiritual fortitude, and religious motivations. CONCLUSIONS: Results suggest disaster survivors are only modestly accurate in perceiving how much positive R/S change they experience following a disaster. We discuss implications for clinical practice, scientific research, and empirical and conceptual work on PTG more broadly.

The Enneagram: A systematic review of the literature and directions for future research.

The Enneagram is a typology that many clients use to understand their personality and interpersonal patterns, despite some concerns about its validity. Thus, the purpose of this review is to provide a comprehensive and clinician-friendly review of the extant empirical work on the Enneagram. After reviewing 104 independent samples, we found mixed evidence of reliability and validity. In terms of strengths, some factor analytic work has shown partial alignment with prior theorizing, and subscales show theory-consistent relationships with other constructs such as the Big 5. Also, several studies found the Enneagram was helpful for personal/spiritual growth. However, factor analytic work has typically found fewer than nine factors, and no work has used clustering techniques to derive the nine types. Also, there is little research supporting secondary aspects of Enneagram theory, such as wings and intertype movement. We conclude by highlighting directions for future research and implications for clinical practice.

Inquiry-based stress reduction: A systematic review of the empirical literature.

OBJECTIVE: This paper reviewed the empirical research on inquiry-based stress reduction (IBSR; also called "The Work"), which has similarities to third-wave cognitive behavioral approaches such as Acceptance and Commitment Therapy (ACT). Widely used as a self-help intervention, IBSR has only recently been subjected to empirical research. METHOD: We reviewed empirical studies (published and unpublished) that examined IBSR. RESULTS: We found 17 empirical studies (15 independent samples) that examined IBSR. Several studies reported positive changes on variables such as stress, anxiety, and well-being. However, only three studies evaluated IBSR using randomized clinical trials (RCTs). Concerns related to treatment feasibility and cost-effectiveness of IBSR are noted. CONCLUSIONS: There are some promising initial findings on IBSR. However, additional research employing high-quality research designs is necessary to explore the efficacy and effectiveness of IBSR in various contexts.

Targeted Strategy to Analyze Antiepileptic Drugs in Human Serum by LC-MS/MS and LC-Ion Mobility-MS.

Routine small-molecule analysis is challenging owing to the need for high selectivity and/or low limits of quantification. This work reports a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify 14 antiepileptic drugs (AEDs) in human serum. For the optimized LC-MS/MS method described herein, we applied the guidelines outlined in the Clinical and Laboratory Standards Institute (CLSI) LC-MS C62-A document and the U.S. Food and Drug Administration (FDA) Bioanalytical Method Validation Guidance for Industry to evaluate the quality of the assay. In these studies, AED linearity, analyte recovery, matrix effects, precision, and accuracy were assessed. Using liquid chromatography-drift tube ion mobility-mass spectrometry (LC-DTIM-MS), a qualitative method was also used to increase confidence in AED identification using accurate mass and collision cross section (CCS) measurements. The LC-DTIM-MS method was also used to assess the ability of drift tube CCS measurements to aid in the separation and identification of AED structural isomers and other AEDs. These data show that another dimension of information, namely CCS measurements, provides an orthogonal dimension of structural information needed for AED analysis. Multiplexed AED measurements using LC-MS/MS and LC-DTIM-MS have the potential to enable better optimization of dosing owing to the high precision capabilities available in these types of analytical studies. Taken together, these data also show the ability to increase confidence in small-molecule identification and quantification using these analytical technologies.

A latent change score analysis of emotion regulation difficulties and evaluative threat in STEM.

We examined implications of evaluative threat on the ability to regulate emotions for first-time college freshmen completing Science, Technology, Engineering, and Math (STEM) majors (N = 432). Students completed the Evaluative Threat in STEM Scale (Ahlqvist, London, & Rosenthal, 2013) and the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) at six intervals. Cross-sectional and longitudinal measurement invariance was supported. Women reported greater evaluative threat than men, but they did not differ from men in difficulties regulating emotion. Both constructs showed moderate relative stability over time. Using latent change score analyses, significant positive deceleration change patterns indicated that four of the emotion regulation difficulties (Lack of Emotional Awareness, Lack of Emotional Clarity, Impulse Control Difficulties, and Nonacceptance of Emotional Responses) and evaluative threat tended to increase (worsen) over the year, but the increases also slowed (i.e., plateaued) over time. Compared with men, women initially reported higher evaluative threat than men did, but these differences decreased over the year, as women decelerated more quickly than men did. In terms of cross-coupling effects, we found that evaluative threat was associated with subsequent difficulty in identifying strategies to cope with unpleasant emotions. There were no cross-coupling effects for emotion regulation predicting subsequent change in evaluative threat. Gender moderated the Evaluative Threat-to-DERS coupling effects for Lack of Emotional Clarity, Difficulties in Goal-Directed Behavior, and Nonacceptance of Emotional Responses. We discuss implications of evaluative threat for depleting coping resources and some potential psychoeducational and preventive interventions to support students in STEM majors. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Multicultural Orientation in Psychotherapy Supervision: Cultural Humility, Cultural Comfort, and Cultural Opportunities.

As a complement to multicultural competence, the multicultural orientation (MCO) perspective has been proposed as a pragmatic way to enhance cultural understandings about psychotherapeutic dynamics, processes, and outcomes. Consisting of three core components-cultural humility, cultural comfort, and cultural opportunities-the MCO is considered relevant for both individual and group treatment. However, the MCO perspective has yet to be specifically applied to psychotherapy supervision. Because supervision often provides multicultural oversight for individual and group psychotherapy services, considering the ramifications of MCO for psychotherapy supervision (MCO-S) is important. In this article, the implications of MCO-S are reviewed, with attention given to the impacts of cultural humility, cultural comfort, and cultural opportunities on the supervisor-supervisee relationship. Case examples are provided to illustrate the ways in which MCO can affect the psychotherapy supervision process and outcome. Supervision research possibilities are also proposed.

Creating and Elaborating the Cultural Third: A Doers-Doing with Perspective on Psychoanalytic Supervision.

Although recognized as highly crucial to supervision practice (e.g., Tummala-Narra, 2004), culture has been addressed minimally in the psychoanalytic supervision literature. Calls to remedy that limitation have been made and making culture matter has been identified as a most pressing need for psychoanalytic supervision. But how then do we as supervisors go about doing that? How might we better position culture in, and make culture central to, our psychoanalytic supervisory conceptualization and conduct? We subsequently take up those questions, expanding upon our earlier proposals about cultural humility and the Cultural Third (Watkins and Hook, 2016) by (a) proposing a tripartite multicultural perspective (i.e., cultural humility-cultural comfort-cultural opportunities) as supervision sine qua non; (b) using recognition theory as a way to better understand that very process of Third creation and elaboration; and (c) providing a rupture/repair case example that shows efforts to create and build the Cultural Third in supervision. The Cultural Third is conceptualized as a product of doers-doing with so as to culturally learn together through "not knowing".

Development of the Self-Forgiveness Dual-Process Scale.

Progress in the scientific study of self-forgiveness reveals a need for (a) integration of the extant self-forgiveness literature with general psychological theory, (b) development of measures that reflect nuanced conceptualizations of self-forgiveness, (c) better understanding of the impact of self-forgiveness on personal and interpersonal functioning, and (d) development of evidence-based clinical applications of self-forgiveness. Accordingly, we conceptualized self-forgiveness within the framework of Social Cognitive Theory and developed the Self-Forgiveness Dual-Process Scale to assess value reorientation (VRO) and esteem restoration (ERS) following perceived interpersonal offense. In Study 1, we identified the hypothesized 2-factor structure in a sample of university students (N = 191). For Study 2, we used an independent sample (N = 100) to replicate the factor structure and provide initial evidence of construct validity by exploring associations of value reorientation and esteem restoration with established measures of self-forgiveness, self-punishment, and self-exoneration. In Study 3, we recruited a third sample (N = 66) to assess contributions of value reorientation and esteem restoration to explain variance in offense-related rumination beyond that explained by an existing measure of state self-forgiveness. Overall, findings supported conceptualization of self-forgiveness according to processes of value reorientation and esteem restoration, distinguished self-forgiveness from other responses to wrongdoing, and revealed the unique impacts of value reorientation and esteem restoration on functioning. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Cultural humility: Pilot study testing the social bonds hypothesis in interethnic couples.

The purpose of this study was to explore factors associated with relationship quality in interethnic couples. Specifically, we tested the social bond hypotheses of humility in a sample of 155 individual participants currently in an interethnic relationship. Using a cross-sectional design, participants completed an online survey that included measures of demographics, conflict in their relationship, cultural humility, and relationship quality. We predicted that perceptions of one's partner's cultural humility would mediate the relationship between culturally based ineffective arguing and relationship satisfaction and commitment. Results indicated that cultural humility was positively related to both relationship satisfaction and commitment and negatively related to ineffective arguing. Mediation analyses revealed that approximately 26% of the variance in relationship satisfaction and about 8% of the variance in commitment was explained by the effect of ineffective arguing through cultural humility. Results of this study add to the growing body of evidence for the social bond hypothesis of humility and advance the field of research on interethnic couples by providing quantitative support for themes noted in previous qualitative studies on interethnic couples. (PsycINFO Database Record

Integrating clients' religion and spirituality within psychotherapy: A comprehensive meta-analysis.

Some religious or spiritual (R/S) clients seek psychotherapy that integrates R/S values, while others may be reticent to disclose R/S-related aspects of struggles in a presumably secular setting. We meta-analyzed 97 outcome studies (N = 7,181) examining the efficacy of tailoring treatment to patients' R/S beliefs and values. We compared the effectiveness of R/S-tailored psychotherapy with no-treatment controls, alternate secular treatments, and additive secular treatments. R/S-adapted psychotherapy resulted in greater improvement in clients' psychological (g = 0.74, p < 0.000) and spiritual (g = 0.74, p < 0.000) functioning compared with no treatment and non R/S psychotherapies (psychological: g = 0.33, p < 0.001; spiritual: g = 0.43, p < 0.001). In more rigorous additive studies, R/S-accommodated psychotherapies were equally effective to standard approaches in reducing psychological distress (g = 0.13, p = 0.258), but resulted in greater spiritual well-being (g = 0.34, p < 0.000). We feature several clinical examples and conclude with evidence-based therapeutic practices.

Spirituality and Post-Stroke Aphasia Recovery.

The role of spirituality in post-stroke aphasia recovery has been ignored despite its potential contribution to positive health outcomes, particularly stroke recovery. The present study examines the spiritual experience of adults with aphasia in an effort to better understand the role of one's spirituality in the aphasia recovery process. Thirteen adults with aphasia completed a modified spirituality questionnaire and participated in semi-structured interviews. All participants considered themselves spiritual and reported improvements in communication during post-stroke recovery. Two themes related to spirituality that emerged from the interviews were (a) a greater power being in control of events and (b) a greater power as helper.

The advising alliance for international and domestic graduate students: Measurement invariance and implications for academic stress.

We expanded the focus of a prior study of international graduate student advising relationships (Rice et al., 2009) to examine advising experiences of both international and domestic students. International (n = 434) and domestic (n = 387) students completed the Advisory Working Alliance Inventory (AWAI-S; Schlosser & Gelso, 2001) and measures of advising experiences, perceived academic stress, and desire to change advisor. Measurement invariance analyses suggested that a 23-item AWAI-S showed support for scalar invariance. A bifactor structure showed superior fit to the 3-factor model or a second-order factor model for the AWAI-S. International and domestic graduate students did not differ in ratings of general alliance, academic stress, or desire to change advisors. General alliance was strongly related to less academic stress and less desire to change advisors. International students who felt disrespected by their advisors were more likely to be academically stressed than domestic students. Structured mentoring experiences were associated with lower stress and less desire to change, and this effect was similar in both international and domestic students. Overall, results suggested that the current level of measurement, and possibly theory development, regarding the advisory alliance is good at identifying generic satisfaction but weaker at differentiating components of the alliance.

Cultural humility and racial microaggressions in counseling.

Racial microaggressions may contribute to poor counseling outcomes in racial/ethnic minority clients. The present study examined the occurrence of racial microaggressions in counseling using a large and diverse sample and explored the association between perceived cultural humility of the counselor and racial microaggressions. Racial/ethnic minority participants (N = 2,212) answered questions about the frequency and impact of racial microaggressions in counseling and the characteristics of their counselor. The majority of clients (81%) reported experiencing at least 1 racial microaggression in counseling. Participants most commonly reported racial microaggressions involving denial or lack of awareness of stereotypes and bias and avoidance of discussing cultural issues. There were few differences in racial microaggression frequency or impact based on client race/ethnicity and counselor race/ethnicity. Racially matched clients viewed racial microaggressions as more impactful than did clients who were not racially matched. Client-perceived cultural humility of the counselor was associated with fewer microaggressions experienced in counseling. We conclude by discussing limitations, areas for future research, and implications for counseling.

Thankful for the little things: A meta-analysis of gratitude interventions.

A recent qualitative review by Wood, Froh, and Geraghty (2010) cast doubt on the efficacy of gratitude interventions, suggesting the need to carefully attend to the quality of comparison groups. Accordingly, in a series of meta-analyses, we evaluate the efficacy of gratitude interventions (ks = 4-18; Ns = 395-1,755) relative to a measurement-only control or an alternative-activity condition across 3 outcomes (i.e., gratitude, anxiety, psychological well-being). Gratitude interventions outperformed a measurement-only control on measures of psychological well-being (d = .31, 95% confidence interval [CI = .04, .58]; k = 5) but not gratitude (d = .20; 95% CI [-.04, .44]; k = 4). Gratitude interventions outperformed an alternative-activity condition on measures of gratitude (d = .46, 95% CI [.27, .64]; k = 15) and psychological well-being (d = .17, 95% CI [.09, .24]; k = 20) but not anxiety (d = .11, 95% CI [-.08, .31]; k = 5). More-detailed subdivision was possible on studies with outcomes assessing psychological well-being. Among these, gratitude interventions outperformed an activity-matched comparison (d = .14; 95% CI [.01, .27]; k = 18). Gratitude interventions performed as well as, but not better than, a psychologically active comparison (d = -.03, 95% CI [-.13, .07]; k = 9). On the basis of these findings, we summarize the current state of the literature and make suggestions for future applied research on gratitude. (PsycINFO Database Record