Secure human attachment can promote support for climate change mitigation.

Attachment theory is an ethological approach to the development of durable, affective ties between humans. We propose that secure attachment is crucial for understanding climate change mitigation, because the latter is inherently a communal phenomenon resulting from joint action and requiring collective behavioral change. Here, we show that priming attachment security increases acceptance (Study 1: n = 173) and perceived responsibility toward anthropogenic climate change (Study 2: n = 209) via increased empathy for others. Next, we demonstrate that priming attachment security, compared to a standard National Geographic video about climate change, increases monetary donations to a proenvironmental group in politically moderate and conservative individuals (Study 3: n = 196). Finally, through a preregistered field study conducted in the United Arab Emirates (Study 4: n = 143,558 food transactions), we show that, compared to a message related to carbon emissions, an attachment security-based message is associated with a reduction in food waste. Taken together, our work suggests that an avenue to promote climate change mitigation could be grounded in core ethological mechanisms associated with secure attachment.

Table Correction: Effectiveness of eHealth Smoking Cessation Interventions: Systematic Review and Meta-Analysis.

[This corrects the article DOI: 10.2196/45111.].

Effectiveness of eHealth Smoking Cessation Interventions: Systematic Review and Meta-Analysis.

BACKGROUND: Rapid advancements in eHealth and mobile health (mHealth) technologies have driven researchers to design and evaluate numerous technology-based interventions to promote smoking cessation. The evolving nature of cessation interventions emphasizes a strong need for knowledge synthesis. OBJECTIVE: This systematic review and meta-analysis aimed to summarize recent evidence from randomized controlled trials regarding the effectiveness of eHealth-based smoking cessation interventions in promoting abstinence and assess nonabstinence outcome indicators, such as cigarette consumption and user satisfaction, via narrative synthesis. METHODS: We searched for studies published in English between 2017 and June 30, 2022, in 4 databases: PubMed (including MEDLINE), PsycINFO, Embase, and Cochrane Library. Two independent reviewers performed study screening, data extraction, and quality assessment based on the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. We pooled comparable studies based on the population, follow-up time, intervention, and control characteristics. Two researchers performed an independent meta-analysis on smoking abstinence using the Sidik-Jonkman random-effects model and log risk ratio (RR) as the effect measurement. For studies not included in the meta-analysis, the outcomes were narratively synthesized. RESULTS: A total of 464 studies were identified through an initial database search after removing duplicates. Following screening and full-text assessments, we deemed 39 studies (n=37,341 participants) eligible for this review. Of these, 28 studies were shortlisted for meta-analysis. According to the meta-analysis, SMS or app text messaging can significantly increase both short-term (3 months) abstinence (log RR=0.50, 95% CI 0.25-0.75; I2=0.72%) and long-term (6 months) abstinence (log RR=0.77, 95% CI 0.49-1.04; I2=8.65%), relative to minimal cessation support. The frequency of texting did not significantly influence treatment outcomes. mHealth apps may significantly increase abstinence in the short term (log RR=0.76, 95% CI 0.09-1.42; I2=88.02%) but not in the long term (log RR=0.15, 95% CI -0.18 to 0.48; I2=80.06%), in contrast to less intensive cessation support. In addition, personalized or interactive interventions showed a moderate increase in cessation for both the short term (log RR=0.62, 95% CI 0.30-0.94; I2=66.50%) and long term (log RR=0.28, 95% CI 0.04-0.53; I2=73.42%). In contrast, studies without any personalized or interactive features had no significant impact. Finally, the treatment effect was similar between trials that used biochemically verified or self-reported abstinence. Among studies reporting outcomes besides abstinence (n=20), a total of 11 studies reported significantly improved nonabstinence outcomes in cigarette consumption (3/14, 21%) or user satisfaction (8/19, 42%). CONCLUSIONS: Our review of 39 randomized controlled trials found that recent eHealth interventions might promote smoking cessation, with mHealth being the dominant approach. Despite their success, the effectiveness of such interventions may diminish with time. The design of more personalized interventions could potentially benefit future studies. TRIAL REGISTRATION: PROSPERO CRD42022347104; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347104.

Crimes of passion: When romantic obsession leads to abusive relationships.

OBJECTIVE: This research examines the relationship between passion for a romantic partner and obsessive relational intrusion (ORI) which is defined as repeated and unwanted behaviors toward a partner that invade his/her personal privacy and cause fear for his/her safety. METHOD: Based on the dualistic model of passion, we predicted that obsessive passion (OP) would be associated with fear of abandonment, which in turn would be associated with ORI. In contrast, harmonious passion (HP) should not be associated with ORI. RESULTS: Four studies (N = 1257) supported these predictions. Study 1 found cross-sectional support for these hypotheses from the victim's perspective. Study 2 replicated Study 1 and extended it to the perpetrator's perspective by demonstrating that the relationship between passion and ORI is mediated by fear of abandonment. Study 3 replicated these findings using an experimental manipulation of passion. Study 4 found similar results by experimentally manipulating fear of abandonment, the mediator, to demonstrate its causal influence on ORI. CONCLUSIONS: Taken together, the present results demonstrate that passion and fear of abandonment play an important role in the type of behavior people are willing to pursue to maintain their romantic relationship.

How passionate individuals regulate their activity with other life domains: A goal-systemic perspective.

OBJECTIVE: People that pursue a passionate activity obsessively (vs. harmoniously) tend to neglect (vs. integrate) other important life domains, yet research has been silent on the psychological mechanism explaining these differences in self-regulation. The purpose of this research was to address this gap by testing the role of alternative goal suppression. METHOD: Four studies tested whether harmonious passion is characterized by the pursuit of multifinality, the preference for means that gratify multiple goals simultaneously, whereas obsessive passion is characterized by the pursuit of counterfinality, the preference for means that serves a focal goal to the detriment of other pursuits. Underlying this relationship is the tendency to suppress goals conflicting with one's passion. RESULTS: Study 1 found cross-sectional support for these hypotheses. Study 2 replicated Study 1 and extended it by demonstrating that the relationship between obsessive passion and counterfinal means is mediated by alternative goal suppression. Study 3 replicated these findings using an experimental manipulation of passion. Study 4 found similar results by experimentally manipulating alternative goal suppression, the mediator, to demonstrate its causal influence on means evaluation. CONCLUSIONS: Collectively, the present results demonstrate that passion plays a significant role in the type of means-ends relations preferred for goal pursuits.

A comparison of in-hospital acute myocardial infarction management between Portugal and the United States: 2000-2010.

OBJECTIVE: To compare healthcare in acute myocardial infarction (AMI) treatment between contrasting health systems using comparable representative data from Europe and USA. DESIGN: Repeated cross-sectional retrospective cohort study. SETTING: Acute care hospitals in Portugal and USA during 2000-2010. PARTICIPANTS: Adults discharged with AMI. INTERVENTIONS: Coronary revascularizations procedures (percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) surgery). MAIN OUTCOME MEASURES: In-hospital mortality and length of stay. RESULTS: We identified 1 566 601 AMI hospitalizations. Relative to the USA, more hospitalizations in Portugal presented with elevated ST-segment, and fewer had documented comorbidities. Age-sex-adjusted AMI hospitalization rates decreased in USA but increased in Portugal. Crude procedure rates were generally lower in Portugal (PCI: 44% vs. 47%; CABG: 2% vs. 9%, 2010) but only CABG rates differed significantly after standardization. PCI use increased annually in both countries but CABG decreased only in the USA (USA: 0.95 [0.94, 0.95], Portugal: 1.04 [1.02, 1.07], odds ratios). Both countries observed annual decreases in risk-adjusted mortality (USA: 0.97 [0.965, 0.969]; Portugal: 0.99 [0.979, 0.991], hazard ratios). While between-hospital variability in procedure use was larger in USA, the risk of dying in a high relative to a low mortality hospital (hospitals in percentiles 95 and 5) was 2.65 in Portugal when in USA was only 1.03. CONCLUSIONS: Although in-hospital mortality due to an AMI improved in both countries, patient management in USA seems more effective and alarming disparities in quality of care across hospitals are more likely to exist in Portugal.

COVID-19 may have increased global support for universal health coverage: multi-country observational study.

Introduction: The multiple risks generated by the COVID-19 pandemic intensified the debate about healthcare access and coverage. Whether the burden of disease caused by the coronavirus outbreak changed public opinion about healthcare provision remains unclear. In this study, it was specifically examined if the pandemic changed support for governmental intervention in healthcare as a proxy to support for universal health coverage (UHC). It also examined which psychological factors related to the socioeconomic interdependence exposed by the pandemic may be associated with a potential change. Methods: Online survey data was collected over 18 months (from March 2020 to August 2021) across 73 countries, containing various social attitudes and risk perceptions related to COVID-19. This was a convenience sample composed of voluntary participants (N = 3,176; age 18 years and above). Results: The results show that support for government intervention in healthcare increased across geographical regions, age groups, and gender groups (an average increase of 39%), more than the support for government intervention in other social welfare issues. Factors related to socioeconomic interdependence predicted increased support for government intervention in healthcare, namely, social solidarity (ß = 0.14, p < 0.0001), and risk to economic livelihood (ß = 0.09, p < 0.0001). Trust in the government to deal with COVID-19 decreased over time, and this negative trajectory predicted a demand for better future government intervention in healthcare (ß = -0.10, p = 0.0003). Conclusion: The COVID-19 pandemic may have been a potential turning point in the global public support for UHC, as evidenced by a higher level of consensus that governments should be guarantors of healthcare.

Ideological passion and violent activism: The moderating role of the significance quest.

This research examines how the relationship between passion for an ideology and violent activism is magnified by the personal (vs. collective) loss of significance. In Study 1 (N = 238), the relationship between obsessive (but not harmonious) passion for the Republican Party and violent activism was moderated by personal (but not collective) loss of significance. Study 2 (N = 612) replicated these findings with an experimental manipulation of personal and collective loss of significance in a sample of Black Lives Matter supporters. In Study 3 (N = 416), we set out to attenuate the obsessive passion-violent activism relationship by experimentally manipulating personal and collective significance gain. Echoing the results of Studies 1 and 2, the manipulation of personal (but not collective) significance gain reduced the relationship between obsessive passion for the environmental cause and violent activism. Furthermore, Study 3 examined the psychological mechanism at play by incorporating a measure of goal-shielding - a factor of theoretical relevance to explain extreme behaviour. Personal significance gain reduced individuals' proclivity to inhibit goals unrelated to their ideological pursuit, which in turn reduced their support for violent activism. These findings reveal psychological factors relevant to detecting at-risk individuals and implementing cost-effective prevention programmes against ideological violence.

Predictors of adherence to public health behaviors for fighting COVID-19 derived from longitudinal data.

The present paper examines longitudinally how subjective perceptions about COVID-19, one's community, and the government predict adherence to public health measures to reduce the spread of the virus. Using an international survey (N = 3040), we test how infection risk perception, trust in the governmental response and communications about COVID-19, conspiracy beliefs, social norms on distancing, tightness of culture, and community punishment predict various containment-related attitudes and behavior. Autoregressive analyses indicate that, at the personal level, personal hygiene behavior was predicted by personal infection risk perception. At social level, social distancing behaviors such as abstaining from face-to-face contact were predicted by perceived social norms. Support for behavioral mandates was predicted by confidence in the government and cultural tightness, whereas support for anti-lockdown protests was predicted by (lower) perceived clarity of communication about the virus. Results are discussed in light of policy implications and creating effective interventions.

Lives versus Livelihoods? Perceived economic risk has a stronger association with support for COVID-19 preventive measures than perceived health risk.

This paper examines whether compliance with COVID-19 mitigation measures is motivated by wanting to save lives or save the economy (or both), and which implications this carries to fight the pandemic. National representative samples were collected from 24 countries (N = 25,435). The main predictors were (1) perceived risk to contract coronavirus, (2) perceived risk to suffer economic losses due to coronavirus, and (3) their interaction effect. Individual and country-level variables were added as covariates in multilevel regression models. We examined compliance with various preventive health behaviors and support for strict containment policies. Results show that perceived economic risk consistently predicted mitigation behavior and policy support-and its effects were positive. Perceived health risk had mixed effects. Only two significant interactions between health and economic risk were identified-both positive.

The reactance decoy effect: How including an appeal before a target message increases persuasion.

We propose and demonstrate in 11 studies, including more than 4,700 observations, that the persuasiveness of a target message can be increased by the inclusion of a reactance decoy. A reactance decoy is a persuasive message presented before the target message and includes an attitude measurement toward the decoy object. The effect can be explained with reactance theory: The decoy message is presented to create reactance and expressing their attitude toward the decoy object gives participants the opportunity to vent, that is, to reestablish their threatened freedom. This reduces reactance toward the subsequently presented target message, positively influences participants' willingness to buy the target object (Studies 1, 4a and 4b, 7, and 8), their attitudes toward it (4a and 4b, 5, 7, and 8), their willingness to pay (Study 7), as well as behavioral measures such as time spent looking at the target object description (Study 7) and paying money to enter a raffle for the chance to win the target object (Studies 5 and 6). Moreover, forewarning participants of the persuasive intent of a subsequent message produced greater reactance, which was then vented on the decoy, and in turn increased the valuation of the target object (Study 1). By interchanging the products used as decoy or target objects, we also demonstrate experimentally that the reactance decoy effect occurs independently of the concrete stimuli being used (Study 3). In sum, the reactance decoy effect is a new theoretical framework that also bears important practical applications for many areas of social influence. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Passion for an activity: a new predictor of sleep quality.

STUDY OBJECTIVES: The present research examines the relationship between people's frequent involvement in an activity they like and find important (i.e., a passion) and the quality of their sleep. Research on the dualistic model of passion has widely documented the relationship between individuals' type of passion-harmonious versus obsessive-and the quality of their mental and physical health. However, research has yet to examine the relationship between passion and sleep quality. Building on prior research has shown that obsessive (vs harmonious) passion is related to depressive mood symptoms-an important factor associated with sleep problems-we hypothesized that obsessive passion would be associated with overall worse sleep quality, whereas harmonious passion would predict better sleep quality. METHODS: A sample of 1,506 Americans filled out an online questionnaire on sleep habits and passion. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Hierarchical linear regressions and mediation analyses were carried out with results confirming our hypotheses. RESULTS: Obsessive passion for an activity was associated with worse sleep quality, whereas harmonious passion was associated with better sleep quality, adjusting for demographics, the type of passionate activity and its self-reported importance, alcohol and tobacco consumption, BMI, self-reported health, and diagnosed health conditions. The relationship between both types of passion and sleep quality was mediated by depressive mood symptoms. CONCLUSIONS: Our study presents evidence of a strong relationship between sleep quality and passion, opening the door for future research to create new interventions to improve people's sleep and, consequently, their well-being.

The role of sensation seeking in political violence: An extension of the Significance Quest Theory.

Adventure and excitement have often been invoked to explain why people engage in political violence, yet empirical evidence on the topic has thus far been anecdotal. The present research sought to fill this gap in knowledge by examining the role of sensation seeking in political violence and integrating this concept with Significance Quest Theory (Kruglanski, Chen, Dechesne, Fishman, & Orehek, 2009; Kruglanski et al., 2013). Extending prior research on violent extremism, Study 1 found that sensation seeking mediated the relation between meaning in life and willingness to self-sacrifice and support for political violence. Study 2 established temporal precedence of the variables in the mediation model, using a longitudinal design. Studies 3 and 4 experimentally replicated findings of Studies 1 and 2. In Studies 5a and 5b, we found that sensation seeking predicts support for a real life violent activist group. In Studies 6a and 6b, the positive evaluation of a violent activist group by individuals high in sensation seeking was explained by how exciting they perceived the group to be. Finally, Study 7 introduced an intervention targeting the sensation seeking motive by presenting participants with a peaceful (less exciting vs. exciting) activism group. As hypothesized, providing individuals high in sensation seeking with a peaceful yet exciting group mitigated their support for extreme behavior. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Do Counter-Narratives Reduce Support for ISIS? Yes, but Not for Their Target Audience.

The purpose of this research is to experimentally test whether counter-narratives are effective to reduce people's support and willingness to join Islamic State of Iraq and Syria (ISIS). Integrating psychological reactance theory (Brehm, 1966) and need for closure (NFC; Kruglanski, 2004), we predicted that exposing people to counter-narratives when they are at greater risk of radicalization (high NFC individuals) would be counterproductive and enhance their support for ISIS. Participants (N = 886 American Muslims) were randomly assigned to a 3 × 3 factorial experimental design varying the source (United States Government, Imam, ISIS defector), and the content (social, political, and religious) of the counter-narrative while comparing these groups to a control message. Results show an overall small positive effect of counter-narratives (ß = -0.107, p = 0.043), but also evidence for greater support for ISIS in individuals at greater risk of radicalization (ß = 0.154, p = 0.005). Results also show that the content was more important than the source: A political narrative was the most effective, and this result is consistent across different sources although an ISIS defector is the most effective messenger. These findings challenge the widespread assumption that counter-narratives are effective against violent extremism. In fact, they accelerate the very phenomenon that governments and policy makers are trying to undermine. Therefore, policy makers should avoid including them in their armamentarium to tackle violent extremism.

Parts greater than their sum: randomized controlled trial testing partitioned incentives to increase cancer screening.

Promoting healthy behavior is a challenge for public health officials, especially in the context of asking patients to participate in preventive cancer screenings. Small financial incentives are sometimes used, but there is a little scientific basis to support a compelling description of the best-practice implementation of such incentives. We present a simple behavioral strategy based on mental accounting from prospect theory that maximizes the impact of incentives with no additional cost. We show how the partition of one incentive into two smaller incentives of equivalent total amount produces substantial behavioral changes, demonstrated in the context of colorectal cancer screening. In a randomized controlled trial, eligible patients aged 50-74 (n = 1652 patients) were allocated to receive either one €10 incentive (upon completion of screening) or two €5 incentives (at the beginning and at the end of screening). We show that cancer screening rates were dramatically increased by partitioning the financial incentive (61.1%), compared with a single installment at the end (41.4%). These results support the hedonic editing hypothesis from prospect theory, and underline the importance of implementing theoretically grounded healthcare interventions. Our results suggest that, when patient incentives are feasible, healthcare procedures should be framed as multistage events with smaller incentives offered at multiple points in time.

Meta-analysis of randomised controlled trials testing behavioural interventions to promote household action on climate change.

No consensus exists regarding which are the most effective mechanisms to promote household action on climate change. We present a meta-analysis of randomised controlled trials comprising 3,092,678 observations, which estimates the effects of behavioural interventions holding other factors constant. Here we show that behavioural interventions promote climate change mitigation to a very small degree while the intervention lasts (d = -0.093 95% CI -0.160, -0.055), with no evidence of sustained positive effects once the intervention ends. With the exception of recycling, most household mitigation behaviours show a low behavioural plasticity. The intervention with the highest average effect size is choice architecture (nudges) but this strategy has been tested in a limited number of behaviours. Our results do not imply behavioural interventions are less effective than alternative strategies such as financial incentives or regulations, nor exclude the possibility that behavioural interventions could have stronger effects when used in combination with alternative strategies.

The Atlantic divide in coronary heart disease: Epidemiology and patient care in the US and Portugal.

INTRODUCTION AND OBJECTIVES: We aimed to compare access to new health technologies to treat coronary heart disease (CHD) in the health systems of Portugal and the US, characterizing the needs of the populations and the resources available. METHODS: We reviewed data for 2000 and 2010 on epidemiologic profiles of CHD and on health care available to patients. Thirty health technologies (16 medical devices and 14 drugs) introduced during the period 1980-2015 were identified by interventional cardiologists. Approval and marketing dates were compared between countries. RESULTS: Relative to the US, Portugal has lower risk profiles and less than half the hospitalizations per capita, but fewer centers per capita provide catheterization and cardiothoracic surgery services. More than 70% of drugs were available sooner in the US, whereas 12 out of 16 medical devices were approved earlier in Portugal. Nevertheless, at least five of these devices were adopted first or diffused faster in the US. Mortality due to CHD and myocardial infarction (MI) was lower in Portugal (CHD: 72.8 vs. 168 and MI: 48.7 vs. 54.1 in Portugal and the US, respectively; age- and gender-adjusted deaths per 100000 population, 2010); but only CHD deaths exhibited a statistically significant difference between the countries. CONCLUSIONS: Differences in regulatory mechanisms and price regulations have a significant impact on the types of health technologies available in the two countries. However, other factors may influence their adoption and diffusion, and this appears to have a greater impact on mortality, due to acute conditions.