Pancultural nostalgia in action: Prevalence, triggers, and psychological functions of nostalgia across cultures.

Nostalgia is a social, self-relevant, and bittersweet (although mostly positive) emotion that arises when reflecting on fond past memories and serves key psychological functions. The majority of evidence concerning the prevalence, triggers, and functions of nostalgia has been amassed in samples from a handful of largely Western cultures. If nostalgia is a fundamental psychological resource, it should perform similar functions across cultures, although its operational dynamics may be shaped by culture. This study (N = 2,606) examined dispositional nostalgia, self-reported triggers of nostalgia, and functions of experimentally induced nostalgia in young adults across 28 countries and a special administrative region of China (i.e., Hong Kong). Results indicated that nostalgia is frequently experienced across cultures, albeit better valued in more-developed countries (i.e., higher national wealth and life-expectancy). Nostalgia is triggered by psychological threats (especially in warmer countries), sensory stimuli (especially in more-developed countries), and social gatherings (especially in less-developed countries). The positive or negative affect prompted by experimentally induced nostalgia varied by country, but was mild overall. More importantly, recalling a nostalgic (vs. ordinary) memory increased social connectedness, self-continuity, and meaning in life across cultures. In less-developed countries, recalling an ordinary memory also conferred some of these functions, reducing the effect size of nostalgia. Finally, recalling a nostalgic (vs. ordinary) memory augmented state satisfaction with life in countries with lower quality of living (i.e., lower life-expectancy and life-satisfaction). Overall, findings confirm the relevance of nostalgia across a wide range of cultures and indicate cultural nuances in its functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluating Medical Students' Views of the Complexity of Sexual Minority Patients and Implications for Care.

Purpose: Sexual and gender minority (SGM) people experience many health care disparities. We aimed to determine if medical students viewed sexual minority patients (lesbian, gay, or bisexual [LGB] men/women) as more complex than heterosexual patients, even when presenting with the same symptoms, and whether this perceived complexity affected confidence caring for LGB patients. Methods: A fictional patient with an upper respiratory infection was presented with systematic variation of the patient's sexual orientation across six experimental conditions in an online, vignette-based experimental study. Participants rated their perception of the medical, therapeutic, and social complexity of the patient, and completed a measure of stigma toward SGM people. Finally, participants indicated their confidence caring for the presented patient. Results: Overall, 665 students participated. Participants viewed the LGB patients as more complex across all domains, relative to heterosexual patients. Perceived medical and social complexity predicted lower confidence caring for the patient. Participants reported lower confidence caring for gay male patients with indirect effects of medical and social complexity. LGB identity was broadly and indirectly associated with lower confidence through social complexity. Conclusion: Our results suggest students view LGB patients as more complex compared with heterosexual patients. Medical education programs must provide training about the effects of social biases on clinical judgments and care for LGB patients, as well as build skills to ensure confidence caring for LGB patients.

Where Do Health Professions Students Learn About Pre-exposure Prophylaxis (PrEP) for HIV Prevention?

HIV pre-exposure prophylaxis (PrEP) is critical for ending the HIV epidemic, and a necessary part of health professions education. We present data from a US survey study (N = 2085) about educational experiences (coursework and extracurricular), in which medical, physician assistant, nursing, and pharmacy students received training about HIV risk factors and PrEP. We found a discrepancy between the percentage of courses covering HIV risk factors (84.7%) compared to PrEP (54.6%) for all students (P < .001), and specifically among final-year students (92.0% vs. 59.7%; P < .001). Pharmacology courses were the most common exposure to PrEP (46.0%), and 61.3% of students were introduced to PrEP through an extracurricular experience. Health professions education must present HIV risk factors in conjunction with PrEP. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01265-3.

A National Study of Medical Students' Attitudes Toward Sexual and Gender Minority Populations: Evaluating the Effects of Demographics and Training.

Purpose: Evaluating medical students' attitudes toward sexual and gender minority (SGM) people is important to identify negative attitudes early in education and to design curriculum to mitigate biases. The purpose of this study was to investigate medical students' attitudes toward SGM people as a whole as well as specific populations within the SGM community. We sought to determine whether attitudes toward SGM people differed between students' demographics and training. Methods: We conducted an online survey-based study among 1007 medical students at 12 U.S. medical schools. Participants completed the Attitudes Toward LGBT People Scale and were randomized to complete another scale specific to one group within the SGM community. We evaluated the association between student demographics and medical training and attitudes toward SGM people overall and toward specific SGM populations. This study was conducted between January and June 2020. Results: Overall, we found that medical students had positive attitudes toward SGM people and specific SGM groups. The most important factor affecting medical students' attitudes on all scales was religiosity, as very religious students held less positive attitudes toward SGM people. In addition, cisgender female students held more positive attitudes toward SGM people overall and toward specific SGM populations. Conclusion: Medical education must ensure that future physicians receive comprehensive and culturally competent training to prepare them to care for SGM patients. Based on our findings, this training should include specific content to help medical students identify potential biases toward SGM people, as well as strategies to acknowledge and confront these biases.

Health Profession Students' Awareness, Knowledge, and Confidence Regarding Preexposure Prophylaxis: Results of a National, Multidisciplinary Survey.

BACKGROUND: Preexposure prophylaxis (PrEP) is a highly effective, pharmacologic method of HIV prevention. Despite its safety and efficacy, PrEP prescription remains low in those patients who are at highest risk for HIV infection. One possible reason for this may be the lack of inclusion of PrEP and HIV prevention discussions within the curricula of health professions education. METHODS: An online survey was administered to a cross-sectional sample of future prescribers (osteopathic/allopathic medical and physician assistant students), future nurses, and future pharmacists (n = 2085) in the United States between January and July 2019 to assess and compare awareness of PrEP, PrEP education, PrEP knowledge, and confidence in 2 areas related to PrEP. RESULTS: We show that, overall, awareness of PrEP is high among future health care providers (81.6%), with the future pharmacists reporting the greatest awareness (92.2%; P < 0.001) and more commonly reporting PrEP education (71.0%). Students had mixed knowledge of PrEP, with future pharmacists reporting the highest knowledge of PrEP. Approximately 30% of students in all disciplines reported having low confidence counseling a patient about PrEP and low confidence educating a colleague about PrEP. Knowledge of PrEP was a significant predictor of confidence counseling a patient about PrEP (P < 0.001) and educating a colleague about PrEP (P < 0.001). CONCLUSIONS: This study identifies opportunities to improve and incorporate evidence-based strategies for educating future health care providers about PrEP for HIV prevention within health professions curricula.

Student Education About Pre-exposure Prophylaxis (PrEP) Varies Between Regions of the United States.

BACKGROUND: Daily, oral pre-exposure prophylaxis (PrEP) is an effective and safe prevention strategy for people at risk for HIV. However, prescription of PrEP has been limited for patients at the highest risk. Disparities in PrEP prescription are pronounced among racial and gender minority patients. A significant body of literature indicates that practicing healthcare providers have little awareness and knowledge of PrEP. Very little work has investigated the education about PrEP among health professionals in training. OBJECTIVE: The objective of this study was to compare health professions students' awareness of PrEP and education about PrEP between regions of the US, and to determine if correlations between regional HIV incidence and PrEP use were present. DESIGN: Survey study. PARTICIPANTS: A cross-sectional sample of health professions students (N = 1859) representing future prescribers (MD, DO, PA), pharmacists, and nurses in the US. KEY RESULTS: Overall, 83.4% of students were aware of PrEP, but only 62.2% of fourth-year students indicated they had been taught about PrEP at any time during their training. Education about PrEP was most comprehensive in the Northeastern US, the area with the highest PrEP to need ratio (4.7). In all regions, transgender patients and heterosexual men and women were least likely to be presented in education as PrEP candidates, and men who have sex with men were the most frequently presented. CONCLUSIONS: There are marked differences in education regarding PrEP both between academic programs and regions of the USA.

Individuals who report eating disorder symptoms also exhibit a disrupted fading affect bias in autobiographical memory.

We examined symptoms of disordered eating in the context of autobiographical memory via a phenomenon termed the Fading Affect Bias (FAB). The FAB is the tendency for the affect elicited by thinking about positive past events to fade slower than the affect elicited by thinking about negative past events. In Study 1 via an online survey procedure (Event N = 714), and via a booklet laboratory procedure in both Study 2 (Event N = 916) and Study 3 (Event N = 516) each participant described six (Studies 1 & 3) and four (Study 2) autobiographical events. They rated each event's affect at occurrence, affect at recall, and event rehearsal frequency. Participants also reported their own symptoms of eating concerns. Across studies, eating, shape, and weight concerns each moderated the FAB: above-average ratings were associated with a small FAB or no FAB. In all studies, restrictive eating ratings did not moderate the FAB. These results remained while controlling for event rehearsal frequency. The results clarify the relation between subclinical disordered eating and emotion regulation via the FAB during reminiscence about ordinary life events. We discuss the theoretical and methodological implications of our findings.

Does a person selectively recall the good or the bad from their personal past? It depends on the recall target and the person's favourability of self-views.

In three studies, participants remembered real-life behaviours at Time 1 and attempted to recall them at Time 2. When the recall target was the self, a positivity bias emerged: self-positivity. In Study 3, self-positivity extended to an individual (target) who was liked by the participant, but did it not extend to a disliked target. For this latter target, a negativity bias emerged. For recall targets that were participants' acquaintances, self-positivity in recall was also eliminated in Studies 1 and 3, and a negativity bias in recall emerged in Study 2. Finally, in Study 2 (but not Study 3), the favourability of participants' self-view predicted the magnitude of the self-positivity in self-recall, but it did not predict valence effects in other-recall. Taken together, the results indicate that the link between behaviour valence and recall is moderated by the recall target and the favourability of one's self-view.

Emotions experienced at event recall and the self: Implications for the regulation of self-esteem, self-continuity and meaningfulness.

The intensity of positive affect elicited by recall of positive events exceeds the intensity of negative affect elicited by recall of negative events (fading affect bias, or FAB). The research described in the present article examined the relation between the FAB and three regulatory goals of the self: esteem, continuity and meaningfulness. The extent to which an event contributed to esteem (Study 1), continuity (Study 2) or meaningfulness (Study 3) was related to positive affect at event recall provoked by positive memories and to negative affect at event recall provoked by negative memories. The relation between affect experienced at recall and the three regulatory goals was bidirectional. The results showcase how individuals use recall for self-regulatory purposes and how they implement self-regulatory goals for positive affect.

Lay perspectives on the social and psychological functions of heroes.

Declaring and thinking about heroes are common human preoccupations but surprisingly aspects of heroism that reinforce these behaviors are not well-understood. In four thematically consistent studies, we attempt to identify lay perspectives about the psychological functions served by heroes. In Study 1, participants (n = 189) freely generated open-ended descriptions of hero functions, which were then sorted by independent coders into 14 categories (e.g., instill hope, guide others). In Study 2, in an attempt to identify the most important functions associated with heroes, participants (n = 249) rated how each function corresponded with their personal views about heroes. Results from a confirmatory factor analysis suggested that a three-factor model of hero functions fit the data well: participants thought that heroes enhanced the lives of others, promoted morals, and protected individuals from threats. In Study 3 (n = 242), participants rated heroes as more likely to fulfill a protecting function than either leaders or role models. In Studies 4A (n = 38) and 4B (n = 102), participants indicated that thinking about a hero (relative to a leader or an acquaintance) during psychological threat fulfilled personal enhancement, moral modeling, and protection needs. In all, these findings provide an empirical basis to spur additional research about the social and psychological functions that heroes offer.

The dimensionality of defense-mechanism parcels in the Defense Style Questionnaire-40.

The Defense Style Questionnaire-40 (DSQ-40; Andrews, Singh, & Bond, 1993) uses pairs of items to measure 20 individual defense mechanisms. In a statistical sense, these item pairs represent parcels and are subject to the standards of unidimensionality demanded of parcels in general. Using a 2-facet modeling approach (N = 672), the present study examined the dimensionality of the defense-mechanism parcels in the DSQ-40 and found that the majority of the parcels did not satisfy the criteria for unidimensionality. In addition, the original 3-factor model of defense styles was not tenable with the present data. Overall, the results suggest caution when attempting to assess individual defense mechanisms using the DSQ-40.

Zeroing in on heroes: a prototype analysis of hero features.

Heroes are ubiquitous in literature and popular discourse, yet little is known about cognitive representations of heroes. We examined lay conceptions of heroes using a prototype approach, compared heroes with other persons of influence, and studied how individuals use hero features to identify heroes. In Study 1, participants (N = 189) generated open-ended descriptions of heroes, which were sorted by independent coders into 26 meaningful categories. In Study 2, participants (N = 365) rated the centrality of these features, and subsequently classified each feature as either central (e.g., brave, moral integrity) or peripheral (e.g., humble, proactive). In a reaction time (RT) paradigm, participants in Study 3 (N = 33) identified central features of heroes faster than peripheral features. In Study 4, participants (N = 25) remembered more central hero features than peripheral features in a surprise recall task. In Study 5 (N = 89), participants most strongly identified a hero when the target was described with central features (vs. peripheral or neutral features). In Studies 6 (N = 212) and 7 (N = 307), participants' ratings evidenced that the prototypical features of heroes did not fit conceptually as well for role models and leaders. In all, these studies contribute new ideas to existing knowledge about heroes, and contribute to a shared understanding of what a hero means to people. Our research is thus an important step in refining heroism into a scientific concept. The notion of the prototypical features of heroes provides a basis for future hero research and intervention.

A pancultural perspective on the fading affect bias in autobiographical memory.

The fading affect bias (FAB) refers to the negative affect associated with autobiographical events fading faster than the positive affect associated with such events, a reliable and valid valence effect established by researchers in the USA. The present study examined the idea that the FAB is a ubiquitous emotion regulating phenomenon in autobiographical memory that is present in people from a variety of cultures. We tested for evidence of the FAB by sampling more than 2400 autobiographical event descriptions from 562 participants in 10 cultures around the world. Using variations on a common method, each sample evidenced a FAB: positive affect faded slower than negative affect did. Results suggest that in tandem with local norms and customs, the FAB may foster recovery from negative life events and promote the retention of the positive emotions, within and outside of the USA. We discuss these findings in the context of Keltner and Haidt's levels of analysis theory of emotion and culture.

Pancultural nostalgia: prototypical conceptions across cultures.

Nostalgia is a frequently experienced complex emotion, understood by laypersons in the United Kingdom and United States of America to (a) refer prototypically to fond, self-relevant, social memories and (b) be more pleasant (e.g., happy, warm) than unpleasant (e.g., sad, regretful). This research examined whether people across cultures conceive of nostalgia in the same way. Students in 18 countries across 5 continents (N = 1,704) rated the prototypicality of 35 features of nostalgia. The samples showed high levels of agreement on the rank-order of features. In all countries, participants rated previously identified central (vs. peripheral) features as more prototypical of nostalgia, and showed greater interindividual agreement regarding central (vs. peripheral) features. Cluster analyses revealed subtle variation among groups of countries with respect to the strength of these pancultural patterns. All except African countries manifested the same factor structure of nostalgia features. Additional exemplars generated by participants in an open-ended format did not entail elaboration of the existing set of 35 features. Findings identified key points of cross-cultural agreement regarding conceptions of nostalgia, supporting the notion that nostalgia is a pancultural emotion.

Treatment noncompliance in randomized experiments: statistical approaches and design issues.

Treatment noncompliance in randomized experiments threatens the validity of causal inference and the interpretability of treatment effects. This article provides a nontechnical review of 7 approaches: 3 traditional and 4 newer statistical analysis strategies. Traditional approaches include (a) intention-to-treat analysis (which estimates the effects of treatment assignment irrespective of treatment received), (b) as-treated analysis (which reassigns participants to groups reflecting the treatment they actually received), and (c) per-protocol analysis (which drops participants who did not comply with their assigned treatment). Newer approaches include (d) the complier average causal effect (which estimates the effect of treatment on the subpopulation of those who would comply with their assigned treatment), (e) dose-response estimation (which uses degree of compliance to stratify participants, producing an estimate of a dose-response relationship), (f) propensity score analysis (which uses covariates to estimate the probability that individual participants will comply, enabling estimates of treatment effects at different propensities), and (g) treatment effect bounding (which calculates a range of possible treatment effects applicable to both compliers and noncompliers). The discussion considers the areas of application, the quantity estimated, the underlying assumptions, and the strengths and weaknesses of each approach.

The fading affect bias across alcohol consumption frequency for alcohol-related and non-alcohol-related events.

The Fading Affect Bias (FAB) is the tendency for unpleasant emotions to fade more over time than pleasant emotions (Walker, Vogl, & Thompson, 1997). The FAB is negatively related to dysphoria (Walker, Skowronski, Gibbons, Vogl, & Thompson, 2003), which led researchers to suggest that the FAB is a healthy coping mechanism that improves the overall positivity of life (Walker, Skowronski, & Thompson, 2003). The FAB may also reinforce certain maladaptive behaviors, such as drinking alcohol, as the unpleasant emotions associated with those behaviors quickly fade from memory, and increase the likelihood of those behaviors in the future. If the FAB increases the likelihood of maladaptive alcohol consumption, the FAB should be greatest for ordinary events at low alcohol consumption levels, whereas the FAB should be greatest for alcohol events at high alcohol consumption levels. The results of two studies provided support for the hypotheses. The implications are discussed.

Perceived changes in ordinary autobiographical events' affect and visual imagery colorfulness.

We examined the extent to which the perceived changes in visual imagery colorfulness impact on the affect intensity associated with ordinary autobiographical events across time. We garnered support for the hypothesis that recent events become memorial phenomena via an emotion regulation process such that positive events retained their affective pleasantness longer than negative events retained affective unpleasantness because, in part, across 2 weeks the former retained their imagery colorfulness longer than the latter events did. A similar but distinct model was unsupported. We discuss the significance of imagery colorfulness and affect intensity in the context of memory for everyday autobiographical events.

Odyssey's end: lay conceptions of nostalgia reflect its original Homeric meaning.

Nostalgia fulfills pivotal functions for individuals, but lacks an empirically derived and comprehensive definition. We examined lay conceptions of nostalgia using a prototype approach. In Study 1, participants generated open-ended features of nostalgia, which were coded into categories. In Study 2, participants rated the centrality of these categories, which were subsequently classified as central (e.g., memories, relationships, happiness) or peripheral (e.g., daydreaming, regret, loneliness). Central (as compared with peripheral) features were more often recalled and falsely recognized (Study 3), were classified more quickly (Study 4), were judged to reflect more nostalgia in a vignette (Study 5), better characterized participants' own nostalgic (vs. ordinary) experiences (Study 6), and prompted higher levels of actual nostalgia and its intrapersonal benefits when used to trigger a personal memory, regardless of age (Study 7). These findings highlight that lay people view nostalgia as a self-relevant and social blended emotional and cognitive state, featuring a mixture of happiness and loss. The findings also aid understanding of nostalgia's functions and identify new methods for future research.

Why people rehearse their memories: frequency of use and relations to the intensity of emotions associated with autobiographical memories.

People may choose to rehearse their autobiographical memories in silence or to disclose their memories with other people. This paper focuses on five types of memory rehearsal: involuntary rehearsal, rehearsal to maintain an event memory, rehearsal to re-experience the emotion of an event, rehearsal to understand an event, or rehearsal for social communication. A total of 337 participants recalled event memories, provided estimates of how often each event was rehearsed and for what reason, and rated the affective characteristics of the events. Rehearsal frequency was highest for social communication and lowest for rehearsals aimed at understanding events. For many rehearsal types, rehearsal was more frequent for positive than negative events. Frequently rehearsed events tended to show less affective fading. The pattern changed when events were socially rehearsed. For positive events, increased social rehearsal was related to a reduction in affective fading. For negative events, increased social rehearsal was associated with increased affective fading.

Comparing two perceived characteristics of autobiographical memory: Memory detail and accessibility.

Four samples of participants recalled autobiographical memories. While some evidence emerged from regression analyses suggesting that judgements of the amount of detail contained in each memory and judgements of the ease with which events could be recalled were partially independent, the analyses generally showed that these judgements were similarly predicted by various event characteristics (age, typicality, self-importance, emotional intensity at event occurrence, rehearsal types). Co-occurrence frequency data yielded similar conclusions, showing that while ease ratings and detail ratings occasionally diverged, they were more often consistent with each other. Finally, the data also suggested that events that prompted emotional ambivalence were not judged to be more easily recalled, or to contain more detail, than non-ambivalent events.