Weiner's Attribution-Emotion-Action Model: Uncovering the Mediating Role of Self-Blame and the Moderating Effect of the Helper's Responsibility for the Help Recipient's Behavior.

Seven preregistered experimental studies investigated a potential mediator (self-blame) and moderator (the perceived responsibility of the helper for the help recipient's behavior) of Weiner's attribution-emotion-action model. When participants considered a nonchild close other experiencing depression, higher perceived controllability was related to lower sympathy, which correlated with less willingness to provide support; however, among parents considering their child experiencing depression, perceived controllability was either positively associated with sympathy (study 1) or did not influence sympathy (study 2). Offering an explanation, studies 3a/3b indicated a significantly weaker relationship between controllability and responsibility attributions when the target of help was the participant's child. Study 4 investigated the underlying mechanism. Parents experienced self-blame when the cause was controllable, which lowered the association between controllability and responsibility attributions. Studies 5 and 6 revealed this pattern was not specific to the parent-child relationship but occurred whenever the potential helper felt responsible for the help recipient's behavior.

The paradox of the resident experiencing depression: Higher depression, less favorable help-seeking outcome expectations, and lower help-seeking intentions.

BACKGROUND: Medical residents experiencing depression can cause life-threatening harm to themselves and their patients. Treatment is available, but many do not seek help. METHODS: The current set of three studies investigated whether depressive symptomatology in and of itself served as a help-seeking barrier-and whether expectations of help-seeking benefits provided insight into why this occurred. Nine waves of cross-sectional data were collected from medical residents across several different hospitals in the United States. RESULTS: There was a large negative association between levels of depressive symptomatology and help-seeking intentions (H1) in Studies 1 and 3. In Study 2, this association was significant for one of the two help-seeking measures. For all analyses, studies, and measures, there was a large negative association between residents' levels of depressive symptomatology and agreement that seeking help will lead to positive outcomes (H2). Likewise, there was a moderately large indirect effect for all analyses, studies, and measures such that the association between levels of depressive symptomatology and help-seeking intentions occurred through less favorable expectations of help-seeking benefits (H3). Lower agreement of the benefits associated with help-seeking explained between 43 and 65% of depressive symptomatology's negative association with help-seeking intentions across studies. CONCLUSIONS: The current findings indicate that depressive symptomatology itself represents a help-seeking barrier and underscore the importance of help-seeking expectations in explaining why this occurs. If future studies reveal a causal relationship between the perceived benefits of help-seeking and help-seeking intentions, then increasing such expectations could offer a potential path for increasing resident help-seeking.

Let's come to order: The influence of question order on willingness to register as an organ donor.

RATIONALE: As over 90% of people who register to be organ donors do so at the Department of Motor Vehicles (DMV), DMVs are perceived as a key context for increasing donor registration rates. Scholars have recently noted that the driver's license application itself, including the placement of the donor registration item relative to other questions, can possibly influence donor registration behavior. The goal of the current study was to experimentally investigate this possibility. METHOD: We conducted an experiment using Amazon's Mechanical Turk (MTurk) between March and May of 2021 to investigate the influence of question order on donor registration willingness. Participants received a question regarding their willingness to register either before or after a series of health and legal questions often asked at DMVs. RESULTS: The placement of the donor registration question had a positive effect on registration willingness for non-registered individuals (OR = 2.01, 95% CI [1.59, 2.54]) and previously registered donors (OR = 2.57, 95% CI [2.22, 2.99]). CONCLUSION: Changing the question order of driver's license applications has the potential to influence registration rates.

COVID-19 related disruptions to medical education and perceived clinical capability of new resident physicians: a nationwide study of over 1200 first-year residents.

The COVID-19 pandemic transformed the final year of undergraduate medical education for thousands of medical students across the globe. Out of concern for spreading SARS-CoV-2 and conserving personal protective equipment, many students experienced declines in bedside clinical exposures. The perceived competency of this class within the context of the pandemic is unclear. We designed and distributed a survey to measure the degree to which recent medical school graduates from the USA felt clinically prepared on 13 core clinical skills. Of the 1283 graduates who matched at HCA Healthcare facilities, 90% (1156) completed the survey. In this national survey, most participants felt they were competent in their clinical skills. However, approximately one out of four soon-to-be residents felt they were clinically below where they should be with regard to calling consultations, performing procedures, and performing pelvic and rectal exams. One in five felt they were below where they should be with regard to safely transitioning care. These perceived deficits in important skill sets suggest the need for evaluation and revised educational approaches in these areas, especially when traditional in-person practical skills teaching and practice are disrupted.

Three-in-1,000 and dynamic norms: A mixed-method investigation of novel appeals for influencing organ donor registration.

The current research investigated two rarely used appeals for increasing organ donor registration-both with the potential to backfire. The three-in-1000 appeal explains that less than one percent of people will die in such a way that their organs can be donated. This appeal could heighten awareness that donor registration is needed, but it can also convey that registering is futile. The dynamic norms appeal emphasizes the increasing number of people who are becoming registered donors. This appeal could increase the perceived normative nature of registration, but doing so can also lead potential donors to conclude that enough people are already registered. In Studies 1 and 2, participants recruited from Amazon's Mechanical Turk were randomly assigned to either one of these appeals, and their attitudes toward donor registration and intentions to register as a donor were compared to participants in a no-message control group. Study 2 included a qualitative component where participants were asked to describe their perceptions as to why the message was or was not influential. In both experiments, intentions to register were higher for those in both messaging conditions compared to the control group. Positive attitudes toward organ donation were higher in the three-in-1000 condition compared to the control group for both studies. Those in the dynamic norms condition reported more positive attitudes than the control group in Study 1, but not Study 2. In both studies, there was scant evidence of the messages backfiring. In the qualitative component of Study 2, self-reported reasons for the influence of each method provided insight into how and why these appeals were influential, and indicated signs of underdetection for the dynamic norms message.

Vested in support: Applying vested interest theory to increase support for close others with depression.

Guided by vested interest theory, we assessed whether a lack of stake explains the discrepancy between people having positive attitudes toward their loved one's recovery from depression and the provision of support. We further investigated whether increasing the perceived personal consequences of providing support (i.e. stake) increased willingness to provide support. A stake-boosting message had no direct, but significant indirect effects on willingness to provide support when compared to a control and comparison condition. In summary, increasing stake in a loved one's recovery indirectly increases intentions to provide support.

Increasing help-seeking among people with depression by self-distancing using mental time-travel.

BACKGROUND: Past research indicates that self-distancing through perspective-taking may increase help-seeking intentions among some people with depression. AIMS: The current pre-registered study tested the effect of self-distancing through mental time-travel on help-seeking attitudes, intentions, outcome expectations, and self-stigma. METHODS: Participants with elevated depressive symptomatology who had not yet sought help for current feelings of depression (n = 859) were randomly assigned to a self-distancing writing task, a self-immersive writing task, or a control condition. RESULTS: Help-seeking attitudes were significantly higher in the distancing condition than in the immersive or control conditions. Additionally, self-distancing through mental time-travel resulted in higher help-seeking intentions compared to the control condition but was not significantly different from the immersive condition. The immersive condition was not significantly different from the control for any outcomes. Interactions show that both self-distancing and the immersive task weakened the negative relationship between depression severity and help-seeking attitudes and intentions. CONCLUSION: Extending scholarship investigating self-distancing and help-seeking intentions, results show that self-distancing through mental time-travel can result in more favorable help-seeking attitudes compared to a control.

Psychological reactance and adolescent cannabis use: The role of parental warmth and monitoring.

Psychological reactance (PR) is a psychological state or trait typified by resistant responses to threats to behavioral freedom. PR has been linked with negative health behaviors, including risky substance use; however, factors that may foster approaches to mitigate the impact of PR on these behaviors, as well as rejection of other health promotion communications is less understood. The current studies examined relations between parental warmth and monitoring with trait PR and responses to preventive cannabis communications and usage intentions. Two in-school surveys were administered to two difference samples of middle school students (Study 1, N = 1,416; Study 2, N = 1,118). Path analytic models tested multivariable linkages among relevant parenting variables, PR, and outcomes associated with cannabis use. Follow-up regression analyses explored significant interaction effects. In Study 1 (p <0.001) and Study 2 (p <0.01), parental warmth moderated the relation between monitoring and trait PR: High monitoring was a protective factor only when combined with high warmth. In turn, PR mediated the relationships between parenting practices and cannabis intentions in both studies (p <0.001). In Study 2, PR also was linked with resistance to persuasion via more unfavorable reactions to anti-cannabis appeals (p <0.001). Findings indicated that low parental warmth combined with high parental monitoring was associated with high trait reactance in adolescents, which predisposed them to stronger resistance to preventive communications. Interventions might focus on counseling parents about the likely outcomes of parenting style, and ways to implement beneficial approaches.

Impact of the Las Vegas Mass Shooting Event on the Graduate Medical Education Mission: Can There Be Growth from Tragedy?

INTRODUCTION: Our aim was to determine the psychological and educational impact of the 2017 Las Vegas mass shooting on the graduate medical education (GME) mission within two cohorts of resident physicians and attending faculty at two nearby academic trauma centers. METHODS: A cross-sectional survey assessed 55 resident physicians and attending faculty involved in the acute care of the patients from the mass shooting. We measured the psychological impact of the event, post-traumatic growth, team cohesion, social support, and known risk factors for post-traumatic stress disorder (PTSD). Additionally, we assessed the impact of the event on GME-specific tasks. RESULTS: Attending faculty and physicians in training in GME residencies evaluated over 300 penetrating trauma patients in less than 24 hours, and approximately 1 in 3 physicians had a patient die under their care. Despite this potential for psychological trauma, the majority of clinicians reported minimal distress and minimal impact on GME activities. However, 1 in 10 physicians screened positive for possible PTSD. Paradoxically, the minority of physicians who sought psychological counseling after the event (20%) were not those who reported the highest levels of distress. Residents generally assessed the event as having an overall negative impact on their educational goals, while attendings reported a positive impact. Psychological impact correlated inversely with social support and the amount of prior education relating to mass casualty incidents (MCI) but correlated directly with the degree of stress prior to the event. CONCLUSION: Despite the substantial level of exposure, most resident physicians did not report significant psychological trauma or an impact on their GME mission. Some reported post-traumatic growth. However, a minority reported a significant negative impact; institutions should consider broad screening efforts to detect and assist these individuals after a MCI. Social support, stress reduction, and education on MCIs may buffer the effects of future psychologically traumatic events on physicians in training.

From writing tasks to a public service announcement: Experimentally assessing savoring as a means of increasing help-seeking for depression.

RATIONALE: Prior studies that used positive emotion infusions (PEIs) to increase help-seeking for depression found initial support for the approach (Siegel & Thomson, 2016; Straszewski & Siegel, 2018, 2020). However, as people with depression experience negative biases that may be maximized when self-relevance is high (Clark et al., 1999), a potential way to maximize the effect of the PEI approach may be to reduce self-focus. OBJECTIVE: We used two preregistered studies (US; 2/19/19 to 9/25/19) to identify the strongest version of a savoring writing task for the current context (Study 1) and test it in the form of a savoring-public service announcement (Study 2; S-PSA). METHODS: Study 1 (N = 1308) compared five savoring writing tasks that varied in self-focus to a control writing task: vicarious, self-distanced, relational, combination, and personal savoring. Study 2 (N = 1238) compared a relational S-PSA to a comparison PSA and a basic control video on help-seeking attitudes, intentions, and behavior. RESULTS: In Study 1, relational savoring was associated with greater help-seeking intentions than the combination savoring condition among all participants and greater help-seeking intentions than the control among participants who self-reported paying full attention during the study. In Study 2, the S-PSA did not perform better than the comparison PSA or basic control video on the outcome measures. CONCLUSIONS: The present research highlights three important takeaways. 1) Researchers should continue to explore relational savoring as an approach to increase help-seeking for depression. 2) Similar to findings of prior depression help-seeking studies, crowdsourcing platforms may be useful for testing informational videos but less appropriate for testing videos that require deep levels of thinking for people experiencing heightened depressive symptomatology. 3) From a theoretical and methodological standpoint, these studies underscore the value of conceptual replications using multiple methods.

Organ donation and departments of motor vehicles: Multiple messages, implementations, and replications.

OBJECTIVE: To reduce uncertainty about the effectiveness of Departments of Motor Vehicles (DMV) interventions, we assessed the influence of several DMV-based media campaigns on organ donor registration. METHOD: Across 4 studies, campaigns were implemented in 8 (Studies 1-3) or 9 (Study 4) New Mexico DMVs. Three theories guided message development (i.e., efficacy, altruism, vested interest). Donor registration was the outcome measure. RESULTS: In Study 1, both the efficacy (OR = 1.14) and altruism (OR = 1.11) campaigns resulted in significantly more registrations than the control condition and the vested interest campaign. In Study 2, the efficacy campaign (OR = 1.13) again resulted in significantly more registrations than the control and vested interest campaign. In Study 3, a new version of the efficacy campaign (OR = 1.21) and 2 new versions of the vested interest campaigns (OR = 1.12; 1.14) all resulted in significantly more registrations than the control condition. In Study 4, neither the efficacy campaign (OR = 1.06) nor a campaign that combined efficacy and vested interest materials (OR = 1.03) significantly increased registrations. A single-paper meta-analysis assessing these studies indicated all 3 appeals resulted in significantly greater registrations than the control (OR ranged from 1.06 to 1.13). CONCLUSION: Results indicate donor registration rates can be increased through DMV-based media campaigns; however, the appeal used, and the implementation of that appeal, can determine the likelihood of success. These results can guide the development and implementation of campaigns seeking to influence donor registration and other prosocial behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Rebuttal-Based Social Norms-Tailored Cannabis Intervention for At-Risk Adolescents.

Many past cannabis prevention campaigns have proven largely ineffective due in part to the diversity of adolescents' cannabis-relevant beliefs. The current studies evaluated the impact of a sequential multiple message approach tailored to the usage norms of adolescents expressing negative attitudes toward a cannabis prevention appeal. A multiple-message strategy was implemented-initial unfavorable message evaluations were invalidated using attitudinal rebuttal feedback prior to presenting a third tailored communication. Participants were cannabis-abstinent middle and high school students (ages 11 to 16). Study 1 (N = 808) compared effects of gain- and loss-framed messages tailored to each student's normative usage perceptions. In Study 2 (N = 391), students were randomly assigned to receive a tailored or non-tailored message after receiving feedback meant to destabilize anti-message attitudes. For at-risk adolescents in Study 1 who perceived cannabis use as normative, a tailored gain-framed message resulted in the lowest usage intentions (p < .05). In Study 2, a conditional multiple-moderated mediation model showed that for high-risk teens with normative beliefs and pro-cannabis attitudes, exposure to a tailored gain-framed communication was associated with decreased cannabis attitude certainty, and lower usage intentions 2 months later (p < .05). Findings have implications for sequential messaging utilization in mass media campaigns and support the efficacy of tailored messages over a one-size-fits-all media approach. Further, results suggest that systematically weakening resistance to persuasive communications and tailoring messages consistent with individually perceived peer norms is an effective prevention strategy.

It's all relative: Increasing organ donor registration intentions by maximizing family-relevant vested interest.

Guided by vested interest theory, the impact of educating potential organ donors about the beneficial experiences afforded to families of deceased donors was assessed. Participants were informed about these benefits by taking a survey that asked them to indicate both their awareness, and the appeal, of numerous existing benefits (e.g. grief services). We employed a double-sided mixed design. Both the true experimental design and the quasi-experimental repeated assessment indicated increased registration intentions. Only the quasi-experimental design indicated significant attitude change. This study provides evidence supporting the potential utility of focusing interventions on the benefits afforded to donor families.

Differential Effects of High- and Low-Arousal Positive Emotions on Help-Seeking for Depression.

BACKGROUND: The current set of pre-registered studies tested the effect of savoring a high-arousal (exciting) or low-arousal (calm) positive experience on help-seeking intentions among people with heightened depressive symptomatology. METHODS: Across all three studies, participants with heightened depressive symptomatology who had not yet sought help were randomly assigned to complete a 6-minute writing task where they reflected on an exciting memory, a calm memory, or what they did today and yesterday. RESULTS: Savoring an exciting memory was associated with significantly greater arousal than savoring a calm memory and the control condition (Study 1; N = 218). Both savoring conditions were associated with greater positive emotion than the control condition (Study 2; N = 193). In Study 3 (N = 1,238), savoring an exciting memory, when compared to the control condition, increased help-seeking intentions, whereas savoring a calm memory did not. CONCLUSIONS: The current studies support the use of high-arousal, rather than low-arousal, positive emotions to increase help-seeking intentions among people with depression.

Preventing college student nonmedical prescription stimulant use: Development of vested interest theory-based persuasive messages.

Vested interest theory (VIT) predicts that perceived importance and hedonic relevance of an expected behavioral outcome affects attitude-behavior consistency. Applied to college students' nonmedical use of prescription stimulants (NUPS), the theory posits that persuasive information that weakens vested perceptions regarding assumed advantages of stimulant misuse will reduce usage intentions. The current study developed and experimentally assessed persuasive messages that targeted perceptions of vested interest (VI), and examined if message effectiveness varied as a function of users' risk status. Appeals that focused on the physical harms of misuse served as the comparison condition. College student participants (N = 282) were randomly assigned to one of four message conditions. To examine group differences, data were analyzed in a 2 (VIT-based message: yes, no) × 2 (Physical harms emphasized: yes, no) × 3 (User status: resolute, vulnerable, user) between-subjects factorial design. Analyses showed that messages focused on lowering VI by convincing students that NUPS did not enhance cognitive functioning of non-ADD/ADHD students reduced perceived vested interest (p < .001) and attitude favoribility p = .005. In vulnerable nonusers, these messages also decreased NUPS intentions p = .006. The effect of exposure to the physical harm communication was not significant. Findings support the potential of VIT-guided messages in NUPS prevention, and the lack of effect of messages focused on physical consequences of misuse.

Self-distancing as a path to help-seeking for people with depression.

OBJECTIVE: Three studies explored whether self-distancing, a method where the self is treated as an other, can impact help-seeking among those with depression. Self-distancing was expected to reduce the negative biases associated with depression by minimizing self-relevance through taking the perspective of an objective other. We hypothesized that when thinking about a past experience of help-seeking, a selfdistancing prompt would cause increased help-seeking intentions and more favorable help-seeking outcome expectations. The influence of selfdistancing on the self-stigma of help-seeking was also explored. METHODS: Participants were randomly assigned to write (Studies 1 and 3) or watch a video (Study 2) where they were prompted to think about helpseeking from their own perspective or an objective other's perspective. Studies 2 and 3 were pre-registered on the Open Science Framework. RESULTS: In Study 1, self-distancing increased help-seeking intentions but did not influence help-seeking expectations or self-stigma. The a priori hypotheses were not supported in Study 2 or 3. However, exploratory analyses of Study 3 revealed an interaction between condition and level of depressive symptomatology indicating that the distancing condition weakened the relationship between higher levels of depressive symptomatology and lower help-seeking intentions, and between higher levels of depressive symptomatology and higher self-stigma. Additionally, analyses of written responses indicated participants in the distancing condition were significantly less likely to write responses void of positive content. CONCLUSION: Although a priori hypotheses were not supported, further research is warranted as results indicate the potential for using self-distancing approaches to increasing help-seeking among some people with depressive symptomatology.

A Mixed Methods Approach to Creating Depression Public Service Announcements by Collaborating with People with Depressive Symptomatology.

Depression is a treatable condition; unfortunately, many do not seek help. Depression public service announcements (D-PSAs) are one means of increasing help-seeking behavior. However, as Beck's cognitive theory of depression indicates, it can be challenging to persuade people with depression. Although there have been successful D-PSAs, some have been ineffective or led to boomerang effects. With the goal of providing guidance for future messages, we use a mixed-methods approach to assess how people with heightened depressive symptomatology perceive motivations and barriers regarding help-seeking. Study 1 participants (N = 186), with and without depressive symptomatology, provided motivations and barriers to seeking help for depression. Study 1's qualitative analysis determined 112 motivations and 124 barriers to help-seeking. Study 2 participants (N= 214), all with heightened depressive symptomatology, rated the motivations and barriers from Study 1 on their attitude function, importance, awareness, and argument strength. This insight guided successful D-PSA creation in a follow-up study, reported elsewhere. The methodological approach utilized, and the specific motivations and barriers revealed, will ideally assist scholars and practitioners seeking to develop future D-PSAs.

Can Mental Health Anti-stigma Messages Have Untoward Effects on Some People with Depression?: An Exploratory Study.

Scholars have warned that mental health anti-stigma campaigns targeting the general public can possibly be detrimental to some who are stigmatized. Scholars also have noted that people with depression respond to some public service announcements (PSAs) differently than those without. Accordingly, the current study explored whether anti-stigma PSAs targeting the general public could cause problematic outcomes for people with depression. Participants with (n = 55) and without (n = 133) heightened depressive symptomatology viewed two mental health anti-stigma PSAs. Participants provided thoughts about the PSAs through a single, open-ended question. To allow for an assessment of convergence, participants rated overall favorability toward each PSA through a close-ended item. Results indicated that most qualitative responses were favorable; however, 23.6% of respondents with heightened depressive symptomatology, compared to 1.5% without, provided responses coded as indicating that at least one PSA caused unintended negative affect, χ2(1) = 25.96, [Formula: see text] p < .001. Evidence of untoward effects primarily came from the Friend PSA and the qualitative responses indicate how this occurred. Moreover, complementing the qualitative coding, the Friend PSA was rated less favorably by participants with heightened depressive symptomatology (M = 5.00, SD = 1.67), than those without (M = 5.64, SD = 1.44), F(1, 186) = 6.99, p = .009, ηp2 = .036. There were no significant differences in quantitative favorability ratings regarding the Labeling PSA. Indicating that further investigation is warranted, results suggest it is possible for an anti-stigma PSA targeting the general public to cause unintended negative affect among some people with depression.

Selective invalidation of ambivalent pro-marijuana attitude components.

INTRODUCTION: Attitudes of drug-abstinent youth considering marijuana initiation can be highly ambivalent. Invalidating pro-usage elements (i.e., opinions) of ambivalent marijuana attitudes, while leaving anti-marijuana elements intact, may create stronger, less ambivalent marijuana-resistant attitudes and lower usage intentions, while concurrently elucidating the role of ambivalence in persuasive prevention. METHOD: From an initial pool of marijuana-abstinent middle-school students (N = 538), the quintile expressing the most negative attitudes toward a marijuana prevention appeal (N = 101) were randomly assigned to one of three conditions designed to invalidate pro-marijuana opinions. Analyses then tested their susceptibility to a second marijuana prevention appeal. RESULTS: Personally threatening messages were found ineffective, but appeals contesting resistant responses significantly decreased ambivalence (p < .01). Mediational analyses showed that this decreased ambivalence was associated with less favorable attitudes and lower marijuana usage intentions (both p < .001). An attribution-based manipulation increased ambivalence (p < .05), which was associated with positive usage intentions mediated through positive attitudes (both p < .001). CONCLUSION: Analyses elucidated the role of attitude ambivalence in prevention, providing a more complete understanding of potential facilitative use of ambivalence in prevention models based on prevention. Results support the further examination and use of methods that invalidate pro-marijuana opinions, thereby leading to greater susceptibility to subsequent prevention appeals.

Measuring Prosociality: The Development of a Prosocial Behavioral Intentions Scale.

Prosociality is a critical issue in behavioral research. In this investigation, we developed a measure of prosocial behavioral intentions. Qualitative responses from two surveys (n = 465) and items from existing measures were used to generate a list of prosocial behaviors in which people might intend to engage. We factor analyzed responses to these items (n = 319) and retained the most common and representative items. The new measure demonstrated adequate internal consistency (n = 247, 147; α = .81, .83); convergent validity with past prosocial behavior (r = .51, .43), moral identity (r = .50, .55), and materialism (r = -.30, -.20). The instrument also predicted prosocial behavior while controlling for a prior measure of prosocial intentions, Exp(B) = 1.99, Wald = 10.59, p = .001, thereby demonstrating incremental predictive validity. This 4-item scale could be used across contexts to advance the study of prosociality.