Disentangling autonomy-supportive and psychologically controlling parenting: A meta-analysis of self-determination theory's dual process model across cultures.

Self-determination theory's (SDT) dual process model claims that parental autonomy support relates positively to child well-being, while psychologically controlling parenting is linked positively to child ill-being. We tested these claims using a combination of one-stage and univariate meta-analytic structural equation modeling with moderation (k = 238; n = 1,040, N = 126,423). In the univariate models, parental autonomy support was linked positively with child well-being, r = 0.30, 95% CI [0.26, 0.33], whereas parental psychological control was positively linked with child ill-being, r = 0.26, 95% CI [0.23, 0.28]. Consistent with SDT's dual process model, the one-stage model that controlled for the intercorrelations between predictors showed that parental autonomy support and psychological control had distinct links to child wellness outcomes. Parental autonomy support was linked positively with child well-being, even when accounting for psychological control, r = 0.26, 95% CI [0.20, 0.31], and parental psychological control was positively linked to child ill-being, controlling for autonomy support, r = 0.20, 95% CI [0.17, 0.23]. Crucially, the beneficial effects of parental autonomy support and the costs of psychological control applied across regions, degrees of national individualism and cultural hierarchy, as well as child developmental periods and sexes. These results help move the field beyond debates about whether autonomy is beneficial toward questions about manifestations of autonomy across groups and variations in its optimal support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

AI Hyperrealism: Why AI Faces Are Perceived as More Real Than Human Ones.

Recent evidence shows that AI-generated faces are now indistinguishable from human faces. However, algorithms are trained disproportionately on White faces, and thus White AI faces may appear especially realistic. In Experiment 1 (N = 124 adults), alongside our reanalysis of previously published data, we showed that White AI faces are judged as human more often than actual human faces-a phenomenon we term AI hyperrealism. Paradoxically, people who made the most errors in this task were the most confident (a Dunning-Kruger effect). In Experiment 2 (N = 610 adults), we used face-space theory and participant qualitative reports to identify key facial attributes that distinguish AI from human faces but were misinterpreted by participants, leading to AI hyperrealism. However, the attributes permitted high accuracy using machine learning. These findings illustrate how psychological theory can inform understanding of AI outputs and provide direction for debiasing AI algorithms, thereby promoting the ethical use of AI.

A meta-analysis of the dark side of the American dream: Evidence for the universal wellness costs of prioritizing extrinsic over intrinsic goals.

Self-determination theory holds that the intrinsic and extrinsic content of people's aspirations differentially affect their wellness. An evidence base spanning nearly 30 years indicates that focusing on intrinsic goals (such as for growth, relationships, community giving, and health) promotes well-being, whereas a focus on extrinsic goals (such as for wealth, fame, and beauty) deters well-being. Yet, the evidence base contains exceptions, and some authors have argued that focusing on extrinsic goals may not be universally detrimental. We conducted a systematic review and used multilevel meta-analytic structural equation modeling to evaluate the links between intrinsic and extrinsic aspirations with indices of well-being and ill-being. Across 92 reports (105 studies), 1,808 effects, and a total sample of N = 70,110, we found that intrinsic aspirations were linked positively with well-being, r = 0.24 [95% CI 0.22, 0.27], and negatively with ill-being, r = -0.11 [-0.14, -0.08]. When the variety of extrinsic aspiration scoring methods were combined, the link with well-being was not statistically significant, r = 0.02 [-0.02, 0.06]. However, when extrinsic aspirations were evaluated in terms of their predominance in the overall pattern of aspiring the effect was universally detrimental, linking negatively to well-being, r = -0.22 [-0.32, -0.11], and positively to ill-being, r = 0.23 [0.17, 0.30]. Meta-analytic conclusions about the associations between goal types and wellness are important because they inform how individuals could shape aspirations to support their own happiness and how groups and institutions can frame goals such that their pursuit is for the common good. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Implications of telehealth services for healthcare delivery and access in rural and remote communities: perceptions of patients and general practitioners.

BACKGROUND: Accelerated by the coronavirus disease 2019 (COVID-19) pandemic, Australia has shifted towards greater use of telehealth to deliver care for rural and remote communities. This policy direction might risk a shift away from the traditional model of informed person-centred care built around care relationships to a technology-mediated health transaction. Potential opportunity costs of widespread telehealth services on the quality of care for rural and remote communities remain understudied. METHODS: A qualitative study was conducted in three local health districts of rural New South Wales, Australia. Data were collected through in-depth interviews. A total of 13 participants was interviewed. Data were analysed using thematic analysis. RESULTS: Patient participants perceived telehealth as an alternative when specialist care was limited or absent. Both patients and clinicians perceived that the deeper caring relationship, enabled through face-to-face interactions, could not be achieved through telehealth services alone, and that telehealth services are often superficial and fragmented in nature. Patients in this study contended that virtual consultations can be distant and lacking in personal touch, and risk losing sight of social circumstances related to patients' health, thereby affecting the trust placed in healthcare systems. CONCLUSIONS: Simply replacing face-to-face interactions with telehealth services has the potential to reduce trust, continuity of care, and effectiveness of rural health services. Telehealth must be used to assist local clinicians in providing the best possible care to rural and remote patients within an integrated service delivery model across diverse rural contexts in Australia.

Do General Practitioners in a Visiting Medical Officer Arrangement Improve the Perceived Quality of Care of Rural and Remote Patients? A Qualitative Study in Australia.

Background: In rural and remote Australia, general practitioners (GPs) provide care across the continuum from primary to secondary care, often in Visiting Medical Officer (VMO) arrangements with a local hospital. However, little is known about the role of GP-VMOs in improving the perceived quality of care and health outcomes for rural and remote communities. Methods: We collected qualitative data from three GP-VMOs (all aged >55 years) and 10 patients (all aged over 65 years) in three local health districts of New South Wales, Australia. Thirteen in-depth interviews were conducted between October 2020 and February 2021. We employed thematic analysis to identify key roles of GP-VMOs in improving the perceived quality of care and health outcomes of rural and remote patients. Results: Our study advances the current understanding regarding the role of GP-VMOs in improving the perceived quality of services and health outcomes of rural and remote patients. Key roles of GP-VMOs in improving the perceived quality of care include promoting the continuity of care and integrated health services, cultivating trust from local communities, and enhancing the satisfaction of patients. Conclusions: GP-VMOs work across primary and secondary care creating better linkages and promoting the continuity of care for rural and remote communities. Employing GP-VMOs in rural hospitals enables the knowledge and sensitivity gained from their ongoing interactions with patients in primary care to be effectively utilised in the delivery of hospital care.

The Prevalence of Psychiatric Disorders in General Hospital Inpatients: A Systematic Umbrella Review.

BACKGROUND: To inform the future development of consultation-liaison psychiatry services, we need accurate information on the prevalence of psychiatric disorders in the general hospital inpatient setting. Systematic reviews have summarized the literature on specific aspects of this broad topic, but there has been no high-level overview that aggregates their findings and identifies gaps in the relevant literature. OBJECTIVE: We aimed to produce a comprehensive overview of the field, summarizing the research literature on the prevalence of psychiatric disorders (i.e., interview-based psychiatric diagnoses) in general hospital inpatients. We did this using a systematic umbrella review (systematic review of systematic reviews), which is the best and most efficient method for summarizing a broad area of research. METHODS: We searched Ovid Medline, Ovid Embase, Ovid PsycINFO, EBSCO CINAHL, and Scopus from database inception to September 2021 for systematic reviews that provided a pooled prevalence estimate, or prevalence range, for interview-diagnosed psychiatric disorders in general hospital inpatients. Two reviewers independently assessed articles and extracted data. The review is registered with PROSPERO, number CRD42019125574. RESULTS: We screened 11,728 articles and included 10 systematic reviews in our umbrella review. We were able to extract pooled prevalence estimates from these as follows: major depression 12% to 20%, any anxiety disorder 8%, generalized anxiety disorder 5%, panic disorder 3%, delirium 15%. We were only able to extract a prevalence range for dementia, which was 3% to 63%. We found no systematic reviews from which we could extract prevalence data for the other psychiatric disorders that we included in our searches, indicating important gaps. From these data, we estimated that approximately one-third of inpatients have a psychiatric disorder. CONCLUSIONS: Psychiatric disorders are very common in general hospital inpatients. While the planning of consultation-liaison psychiatry services will benefit from more research on the prevalence of each of the full range of disorders encountered in the inpatient setting, our findings indicate that we already know enough to justify increased and more population-based service provision.

The left anterior right temporal (LART) placement for electroconvulsive therapy: A computational modelling study.

Electrode placement in electroconvulsive therapy (ECT) has a major impact on treatment efficacy and cognitive side effects. Left Anterior Right Temporal (LART) is a lesser utilised bilateral montage which may produce more optimal clinical outcomes relative to standard bitemporal ECT. In this study we used computational modelling to explore how stimulation effects from LART and two novel variants (LART - F3 and LART - Frontal) compared to the more common bilateral placements of bitemporal and bifrontal ECT. High resolution finite element human head models were generated from MRI scans of three subjects with Major Depressive Disorder. Differences in regional stimulation were examined through parametric tests for regions of interest and subtraction maps. Compared to bitemporal ECT, LART - Original resulted in significantly greater stimulation of the left cingulate gyrus (hypothesised to be associated with treatment efficacy), and relatively reduced stimulation of the bilateral hippocampi (potentially associated with cognitive side effects). No additional clinical benefit was suggested with the novel LART placements compared to the original LART. The original LART placement is a promising montage for further clinical investigation.

Behavioural and neural limits in competitive decision making: The roles of outcome, opponency and observation.

To understand the boundaries we set for ourselves in terms of environmental responsibility during competition, we examined a neural index of outcome valence (feedback-related negativity; FRN) in relation to an early index of visual attention (N1), a later index of motivational significance (P3), and, eventual behaviour. In Experiment 1 (n = 36), participants either were (play) or were not (observe) responsible for action selection. In Experiment 2 (n = 36), opponents additionally either could (exploitable) or could not (unexploitable) be beaten. Various failures in reinforcement learning expression were revealed including large-scale approximations of random behaviour. Against unexploitable opponents, N1 determined the extent to which negative and positive outcomes were perceived as distinct categories by FRN. Against exploitable opponents, FRN determined the extent to which P3 generated neural gain for future events. Differential activation of the N1 - FRN - P3 processing chain provides a framework for understanding the behavioural dynamism observed during competitive decision making.