Validation of the Sexual Discounting Task for Use in Adolescents.

The Sexual Discounting Task (SDT) was developed to evaluate the effects of delay on decision making as it relates to sexual risk-taking behaviors. Though previously validated with other populations, including urban emerging adults, the current study sought to validate the SDT with adolescents. A sample of adolescents (N = 155; 61% female) between ages 14 and 21 (Mage = 19.5 years) was recruited to complete the SDT (involving choices between immediate unprotected sex and delayed sex with a condom with hypothetical sexual partners) and the Delay Discounting Task (a delay discounting task for money outcomes). Additionally, they completed several self-report measures assessing demographics, sexual behavior, and sexual history. If the condom was readily available, respondents were more likely to use a condom for partners who were judged "most likely to have an STI" and for those that participants were "least likely to have sex with." Moreover, when a condom was not immediately available, greater self-reported sexual risk-taking was related to greater sexual discounting (i.e., greater effects of delay on decreasing condom use). Furthermore, sexual discounting was greater among partners deemed more desirable and those judged "least likely to have an STI." Differences in sexual discounting were significant after controlling for immediately available condom use. Findings from the current study suggest that the SDT is clinically meaningful for adolescents and is sensitive to factors that influence real-world decisions to use condoms. Future treatment and prevention should consider delay discounting as an important variable affecting sexual risk behavior.

Comparisons of Explicit Weight Bias Across Common Clinical Specialties of US Resident Physicians.

BACKGROUND: Patients with high body weight are persistently stigmatized in medical settings, with studies demonstrating that providers endorse negative stereotypes of, and have lower regard for, higher-weight patients. Very little is known about how this weight bias varies across specialties. OBJECTIVE: The purpose of this study is to examine how explicit weight bias varies between resident providers among sixteen of the largest residency specialties in the USA. The identification of these differences will guide the prioritization and targeting of interventions. DESIGN: The current study utilized cross-sectional, observational data. PARTICIPANTS: Forty-nine allopathic medical schools were recruited to participate in this national, longitudinal study. The current study utilized data from 3267 trainees in Year 2 of Residency among those who specialized in one of the most common sixteen residency programs in 2016. MAIN MEASURES: Participants reported demographic information and residency specialties and completed three sets of measures pertaining to explicit weight bias. KEY RESULTS: A significant minority (13-48%) of residents reported slight-to-strong agreement with each anti-fat statement. There was a significant relationship between residency specialty and anti-fat blame (F(15, 3189 = 12.87, p < .001), η2 = .06), anti-fat dislike (F(15, 3189 = 7.01, p < .001), η2 = .03), and attitudes towards obese patients (F(15, 3208 = 17.78, p < .001), η2 = .08). Primary care residents (e.g., family medicine, pediatrics) consistently reported lower levels of weight bias than those in specialty programs (e.g., orthopedic surgery, anesthesiology). CONCLUSIONS: This study is the first to report on weight bias in a large, heterogeneous sample of US resident physicians. Problematic levels of weight bias were found in all specialties, with residents in specialty programs generally reporting more bias than those in primary care residencies. Future research should examine which factors contribute to these differences to guide intervention.

A mixed-method analysis of counterfactual thinking, negative event themes, and the transtheoretical model in a community sample of smokers.

The transtheoretical model has been used as a model of behavior change for tobacco users. However, it does not account for perceptions of past behavior that may provide additional guidance toward smoking cessation. No studies have examined associations between the transtheoretical model, content themes of smoking experiences, and counterfactual thoughts (i.e. "If only. . .then. . ."). Mturk participants (N = 178; 47.8% female) completed measures of smoking attitudes, behavior, and stage and processes of change use. Participants described a past negative smoking event and an event-related counterfactual thought-listing task. Participants in the precontemplation stage endorsed fewer processes of change. Also, participants in the action stage reported significantly more counterfactuals about cravings (e.g. If only I could have controlled my urge to smoke. . .) inferring that they may be identifying cravings or urges as relevant barriers toward smoking cessation. Identifying these self-relevant thoughts may provide additional ways to address and overcome barriers toward achieving long-term smoking cessation.

From if-then to here and now: Using personalized counterfactuals from past negative experiences to reduce future alcohol consequences.

College students are at an increased risk for problematic alcohol use. To address this health concern, several interventions have used protective behavioral strategies (PBS). However, interventions promoting PBS remain underdeveloped and underutilized. Counterfactual thinking is a type of postmortem cognitive strategy that highlights causal links between a behavior and a negative outcome. Recent research demonstrates the effectiveness of applying counterfactuals for increasing PBS use intentions. The present study examines the effect of a brief counterfactual-based intervention for increasing PBS use and decreasing adverse alcohol outcomes. Undergraduate students (n = 73) completed an online multiweek (baseline and five weekly follow-ups) intervention. At baseline, participants completed demographics, PBS use, and alcohol use and consequences. They were then randomly assigned to one of three conditions: a control (negative event only), sham (negative event with detailed description), or counterfactual (If only … then …) condition. At weekly follow-up sessions, participants completed PBS use and alcohol use and consequences from the previous week. The counterfactual condition was presented with their counterfactuals generated at baseline. Relative to the active control, the counterfactual condition reported greater use of PBS across the five-week follow-ups. This in turn resulted in decreases in alcohol consumed and alcohol-related consequences. This study highlights the effectiveness of counterfactual thinking as a relevant harm-reduction strategy for alcohol-related outcomes in college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Group differences in binge eating, impulsivity, and intuitive and mindful eating among intermittent fasters and non-fasters.

Intermittent fasting (IF) is an increasingly popular diet involving short-term fasting and/or caloric restriction. While published research highlights physiological effects (e.g., weight, body fat) of IF, hardly any research has examined its associations with psychological factors. This study aimed to investigate the relationship between IF and binge eating, impulsivity, intuitive eating, and mindful eating. An undergraduate sample (N = 298) was recruited through a large southwestern university psychology subject pool. The sample was divided into three groups based on IF status: Current IF (n = 70), Past IF (n = 48), and No IF (n = 182). Current IF was negatively associated with lack of perseverance (e.g., "I generally like to see things through to the end"; p < .01) and intuitive eating (p < .05), varying by subscale, compared to the other groups. Notably, Past-IF, but not Current IF, participants were more likely to binge eat than individuals who reported never fasting (p = .03). These findings add credence to the rapidly developing area of research suggesting IF is associated with increased disordered eating behaviors. Notably, the findings from this study are limited due to the lack of diversity sample, such that generalizations can only be made toward White, middle-to-high income, college students. Future longitudinal studies are needed to test the directionality of these relationships.

Relations Between Adolescent Sensation Seeking and Risky Sexual Behaviors Across Sex, Race, and Age: A Meta-Analysis.

Sensation seeking (SS)-the seeking of novel and intense sensations or experiences and the willingness to take risks for the sake of such experiences-has been shown to be related to various risky sexual behaviors (RSBs) in areas such as multiple sexual partners, condom use, and sexual initiation. The aims of the current meta-analysis were to examine (1) how SS relates to specific RSBs in adolescents and (2) how the overall relationship between SS and RSB differs across sex, race, and age. Overall, a total of 40 studies met the inclusion criteria for our meta-analysis examining the relationship between SS and RSB, contributing 102 effect sizes. RSB variables included unprotected sex; multiple sexual partners; hazardous sexual activity; sexual initiation; virginity status; and history of sexually transmitted disease (STD) diagnosis. Moderating effects of sex, race, and age were also examined. The overall mean effect size of the correlational relationship between adolescent SS and RSB was statistically significant, as were the mean effect sizes of the relationships between SS and RSB subgroups, except for history of STD diagnosis. Race and age did not significantly moderate the overall relationship between SS and RSB; however, results indicated that SS and RSB relations were stronger in females compared to males. Our findings suggest that adolescents with elevations in SS tendencies tend to engage in more RSBs compared to their peers with lower levels of SS, increasing their risk of unplanned pregnancy and STD acquisition.

Ethnicity, age, and education influence perceptions of vegetable healthiness and macronutrient content.

Objective: To assess perceptions of nutritional content and health value of popular vegetables. Design: Cross-sectional online survey. Participants: A total of 760 adults participated in the study. Main Outcome Measures: Likert scale ratings of healthy, calories, carbohydrates, protein, and fiber, for (i) avocado, (ii) romaine lettuce, (iii) white potato, (iv) white onion, and (v) red tomato. Analysis: ANOVAs for continuous variables and Chi-square for categorical variables. Outcomes for nutritional content were compared using separate one-way ANOVAs with ethnicity (Hispanic/Latino vs. non-Hispanic); education (college degree/no college degree); age (18-34, 35-50, 51-70, 70 + ); and diabetes status (with or without diabetes) as the grouping variables. Results: Significant ethnicity effects were found for avocado, lettuce, potato, onion, and tomato. Education level effects were found for avocado, lettuce, potato, and tomato. Age level effects were found for avocado, lettuce, potato, and tomato. Conclusions and Implications: Participant perceptions of the macronutrient content of common vegetables and fruits largely coincided with the US Department of Agriculture values. However, stratifying by ethnicity, age, and education revealed significant differences in both macronutrient perceptions and perceived healthiness. There were no consistent, significant results for interactions of ethnicity by education, nor ethnicity by age. These results suggest that dietary interventions may need to be adjusted based on participant sociodemographic characteristics linked to the perceptions of nutritional value and healthiness.

Development and Validation of a Validity Scale for Use with the UPPS-P and Short UPPS-P Impulsive Behavior Scales.

Two of the most widely used self-report measures of impulsivity are the UPPS-P Impulsive Behavior Scale and its shortened version, the SUPPS-P, which currently are limited by their inability to detect careless and/or random responding. The present study develops and cross-validates an inconsistency scale for use with the UPPS-P and SUPPS-P in order to accurately screen for data quality and better detect invalid responding. A total of 443 participants were recruited from Amazon's MTurk online data collection service to serve as the derivation sample and 231 undergraduates were recruited to serve as the cross-validation sample. The inconsistency scale demonstrated good classification accuracy in differentiating between genuine and random protocols and moderated the relationships between the UPPS-P/SUPPS-P and a criterion measure of impulsivity, the Barratt Impulsiveness Scale-11 (BIS-11). Thus, the inconsistency scale shows promise as an indicator of variable response inconsistency for use with both the UPPS-P and SUPPS-P in community and undergraduate research samples.

Problematic Mobile Phone and Smartphone Use Scales: A Systematic Review.

The popularity of smartphones is undeniable in nearly all facets of society. Despite the many benefits attributed to the technology, concern has grown over the potential for excessive smartphone use to become problematic in nature. Due to the growing concerns surrounding the recognized and unrecognized implications of smartphone use, great efforts have been made through research to evaluate, label and identify problematic smartphone use mostly through the development and administration of scales assessing the behavior. This study examines 78 existing validated scales that have been developed over the past 13 years to measure, identify or characterize excessive or problematic smartphone use by evaluating their theoretical foundations and their psychometric properties. Our review determined that, despite an abundance of self-report scales examining the construct, many published scales lack sufficient internal consistency and test-retest reliability. Additionally, there is a lack of research supporting the theoretical foundation of many of the scales evaluated. Future research is needed to better characterize problematic smartphone use so that assessment tools can be more efficiently developed to evaluate the behavior in order to avoid the excessive publication of seemingly redundant assessment tools.

Does mindfulness reduce the effects of risk factors for problematic smartphone use? Comparing frequency of use versus self-reported addiction.

BACKGROUND: There is growing concern regarding problematic smartphone overuse. Practiced mindfulness, the state of being aware of the present moment, may protect against problematic smartphone use by reducing the strength of risk factors. PURPOSE: We hypothesized that trait mindfulness can reduce the impact of risk factors on a) objective smartphone use and b) subjective problematic smartphone use. METHODS: Our sample (n = 135, Mage = 19.15, 68% female) consisted of college students from a large university. Participants completed self-report measures of boredom proneness, impulsivity, technology-related anxiety (nomophobia), trait mindfulness, smartphone use frequency, and problematic use. RESULTS: Higher mindfulness was significantly associated with lower boredom proneness, impulsivity, and problematic use (F = 12.12, p < .01). Hierarchical regression revealed that the positive relationships between nomophobia, and problematic use decreased as mindfulness levels increased. A similar protective effect was observed for boredom proneness, although the effect dissipated as impulsivity rose. A second regression revealed no significant predictors of weekly smartphone use. CONCLUSIONS: Effects of nomophobia and boredom proneness on problematic smartphone use diminish with increased mindfulness, but impulsivity may interfere with this. Risk and protective factors for 'addiction' appear unrelated to smartphone use frequency. Future research should examine benefits of mindfulness-based interventions in promoting emotional and cognitive self-regulation, focusing on those who use smartphones in dysfunctional ways.

Sensation seeking, sexual orientation, and drug abuse symptoms in a community sample of emerging adults.

Increased use of drugs is associated with a number of factors including high sensation seeking and sexual minority status (through group-specific minority stress). We sought to examine how personality traits like sensation seeking may influence drug abuse among sexual minority individuals. Participants were 217 emerging adults (Mage = 20.23, SD = 0.85) recruited from Amazon Mechanical Turk (MTurk). Of these participants, 67.7% identified as heterosexual, 9.7% as gay or lesbian, 21.2% as bisexual, and 1.4% indicated other sexual orientations. Sensation seeking and drug abuse were self-reported using the Brief Sensation Seeking Scale and the Drug Abuse Screening Test, respectively. A preliminary multiple analysis of variance indicated no significant mean differences for these variables as a function of sex or sexual orientation. Next, sexual minority status, Brief Sensation Seeking Scale scores, sex and their interactions were entered into a linear regression predicting Drug Abuse Screening Test scores. Results revealed a significant moderation, such that the positive relationship between Brief Sensation Seeking Scale total scores and Drug Abuse Screening Test total scores was stronger for sexual minorities (ß = 0.14, P = 0.00) compared to heterosexuals (ß = 0.04, P = 0.04), controlling for sex. These results demonstrate, while sensation seeking and sexual minority status may selectively indicate risk for drug use, sexual minorities high in sensation seeking may be at especially high risk for problems related to drug abuse. More research examining the addiction etiology of sexual minority individuals would inform targeted interventions for this population.

The relationship between impulsivity and shame and guilt proneness on the prediction of internalizing and externalizing behaviors.

Shame and guilt are responses to moral transgressions that are characterized by negative self-evaluations and negative behavioral-evaluations, respectively. Previous research has found shame to be the more maladaptive of these "self-conscious" emotions due to its association with various health-risk behaviors. In the current study, undergraduate participants (n = 199) from a large, public university completed behavioral and self-report measures of impulsivity, shame and guilt-proneness, and behavioral tendencies. Exploratory factor analysis and mediation models were used to determine if shame and/or guilt-proneness significantly mediate the relationship between impulsivity and internalized/externalized problems. Findings demonstrate that impulsivity and shame proneness both positively predict internalized and externalized problem behavior, but indirect effects of shame and guilt are not significant. These findings indicate that shame and guilt do not reliably mediate the relationship between impulsivity and problem behavior, but they do support previous findings on the maladaptive nature of impulsivity and shame. Implications for the protective nature of guilt proneness are also discussed.

Are relationships between impulsivity and depressive symptoms in adolescents sex-dependent?

INTRODUCTION: Both depressive symptomology and impulsivity are common during adolescence and are associated with various negative life outcomes. The potential sex-dependent nature of relationships between these constructs needs further exploration in order to understand their complexities. This cross-sectional study examined how levels of these constructs may differ by sex. Additionally, we investigated whether sex moderates relationships between adolescents' depression symptoms and different facets of impulsivity. METHODS: 156 adolescents (M age = 17.37, SD = 1.91, 59% female) completed self-report measures of their demographics, depression symptoms, and impulsivity. Multiple Analysis of Covariance (MANCOVA) assessed mean differences in depression symptoms and impulsivity by sex and race/ethnicity. Moderation analyses examined how sex may indirectly affect relationships between depression symptoms to predict attentional, motor, and non-planning impulsivity facets, as well as overall trait impulsivity. RESULTS: Correlations between depression symptoms and impulsivity scores were significant. Baseline depression symptoms were significantly higher among females (M = 9.53) compared to males (M = 6.68). Moderation effects of sex were not significant for attentional, motor, or overall trait impulsivity. However, sex moderated relations between depression symptoms and non-planning impulsivity, such that adolescent males showed higher levels of non-planning impulsivity when they reported high levels of depressive symptoms (B = .32, p < .01). This relationship was not significant for females. CONCLUSIONS: While adolescent females may be more prone to depression, adolescent males may be more likely to experience non-planning impulsivity when experiencing symptoms of depression. The results of this study extend the literature regarding sex differences in vulnerabilities between these constructs. We suggest interventions targeting non-planning impulsivity may be especially salient for adolescent males reporting high levels of depressive symptoms.

Does Pain Affect Preference? The Effect of Tonic Laboratory Pain on Discounting of Delayed Rewards.

Chronic pain patients show elevated risk behavior on decision-making tasks, as well as increased health risk behaviors (eg, smoking, prescription opioid abuse). Determining pain's effect on underlying cognitive processes that are associated with risk behavior is confounded by comorbidities linked with chronic pain, including depression, anxiety, and substance abuse. Therefore, to understand pain's effect on delay discounting, a behavioral process assessing the extent to which outcomes are devalued as a function of their delay, the present study evaluated the effect of laboratory pain on delay discounting in healthy young adults (N = 85). Using a mixed factorial design, pain (topical capsaicin and warmth) as well as active control (warmth) groups completed a delay discounting task before and during exposure to their respective manipulations. Whereas the pain condition had no effect on delay discounting, participants' pain intensity, unpleasantness, and pain-induced negative valence were associated with less discounting of delayed rewards. However, the effects were very small. PERSPECTIVE: The results suggest that experimental pain may not increase delay discounting, rather sensitivity to pain predicts a very small decrease in discounting of delayed rewards. Although the results are limited to healthy volunteers, this experimental approach allows us to examine the relationship between pain and delay discounting in a controlled manner. Better understanding of pain-related decision-making may lead to improved treatment of health risk behaviors for individuals experiencing pain.

The Role of the Therapeutic Relationship in Psychopharmacological Treatment Outcomes: A Meta-analytic Review.

OBJECTIVE: Patient nonadherence to psychopharmacological treatment is a significant barrier to effective treatment. The therapeutic relationship is known to be a critical component of effective psychological treatment, but it has received limited study. A meta-analysis was conducted to examine the role of the therapeutic relationship in the delivery of effective psychopharmacological treatment. METHODS: PubMed, PsycINFO, CINAHL, Google Scholar, Ingenta, and the Web of Science-Science Citation Index were searched, including reference lists of found articles. Meta-analytic methods were used to examine the association between the physician-patient therapeutic relationship and outcomes in psychopharmacological treatment. RESULTS: Eight independent studies of psychopharmacological treatment reported in nine articles met the inclusion criterion (1,065 participants) of being an empirically based study in which measures of the therapeutic relationship were administered and psychiatric treatment outcomes were assessed. The overall average weighted effect size for the association between the therapeutic relationship and treatment outcomes was z=.30 (95% confidence interval=.20-.39), demonstrating a statistically significant, moderate effect. CONCLUSIONS: Findings indicate that a positive therapeutic relationship or alliance between the physician and the psychiatric patient is associated with patient improvement over the course of psychopharmacological treatment. Results suggest that more attention should be paid to psychiatrist communication skills that may enhance the therapeutic alliance in psychopharmacological treatment.

The relationship between stress and delay discounting: a meta-analytic review.

The objective of the present meta-analytic review was two-fold: (a) to address the mixed findings of previous research by determining the relationship between stress and impulsivity; and (b) to examine age differences in this relationship. A total of 16 articles fulfilled the inclusion criteria for the present meta-analysis for a total sample size of 2189 participants (k=22) ranging in age from 36 months to 71 years. Using the statistical software, Comprehensive Meta-Analysis, Version 2.0 - Hedges's g was computed to estimate the effect size. Results showed that impulsivity was related to stress with a moderate-large effect size (g=0.590). Significant moderating effects were found for the type of stress measure (g=0.592) and the type of discounting measure (g=0.696) used. The current study emphasizes the need for further research on the relationship between stress and discounting as additional findings may aid in improving future prevention and intervention programs for health-risk behaviors.

The relation between pain-related fear and disability: a meta-analysis.

UNLABELLED: Within a biopsychosocial framework, psychological factors are thought to play an important role in the onset and progression of chronic pain. The cognitive-behavioral fear-avoidance model of chronic pain suggests that pain-related fear contributes to the development and maintenance of pain-related disability. However, investigations of the relation between pain-related fear and disability have demonstrated considerable between-study variation. The main goal of the current meta-analysis was to synthesize findings of studies investigating cross-sectional associations between pain-related fear and disability in order to estimate the magnitude of this relation. We also tested potential moderators, including type of measure used, demographic characteristics, and relevant pain characteristics. Searches in PubMed and PsycINFO yielded a total of 46 independent samples (N = 9,579) that reported correlations between pain-related fear and disability among persons experiencing acute or chronic pain. Effect size estimates were generated using a random-effects model and artifact distribution method. The positive relation between pain-related fear and disability was observed to be moderate to large in magnitude, and stable across demographic and pain characteristics. Although some variability was observed across pain-related fear measures, results were largely consistent with the fear-avoidance model of chronic pain. PERSPECTIVE: Results of this meta-analysis indicate a robust, positive association between pain-related fear and disability, which can be classified as moderate to large in magnitude. Consistent with the fear-avoidance model of chronic pain, these findings suggest that pain-related fear may be an important target for treatments intended to reduce pain-related disability.

Relationship between weight status and delay discounting in a sample of adolescent cigarette smokers.

Obesity and cigarette smoking are often cited separately as the top two preventable causes of death in the United States; however, little research has explored the factors associated with being both obese and a smoker. Delay discounting is a behavioral characteristic that may underlie both of these conditions/behaviors. Delay discounting describes the extent to which an individual discounts the value of an outcome because of a delay in its occurrence. Higher rates of discounting are often considered as an index of impulsivity and have been linked with obesity and cigarette smoking. No research to date has explored delay discounting in a sample of obese smokers. For this study, adolescent smokers classified as obese (body mass index >95th percentile) and healthy weight (body mass index between the 5th and 85th percentiles) were compared on a laboratory assessment of delay discounting. Obese smokers discounted significantly more by delay than healthy weight smokers. This difference remained statistically significant even after controlling for demographic variables that differed across groups. These findings suggest that the relationships between delay discounting and obesity and cigarette smoking may be additive, such that extreme discounting might proportionally increase the risk of becoming an obese smoker. However, future prospective study is needed to fully determine the veracity of this hypothesis.