The Role of Dyadic Sexual Desire Similarity in Predicting Sexual Behaviors in Cohabitating Couples: An Ecological Momentary Assessment Study.

Although researchers are increasingly paying attention to the dyadic nature of sexual desire and its relevance to sexual and relational outcomes, our understanding of how sexual desire operates on a couple level and how it may influence the occurrence of sexual activity in relationships remains limited. This study used ecological momentary assessments to explore to what extent similarity in levels of desire for sex with one's sexual partner, or dyadic sexual desire, was associated with sexual initiations, receptivity to one's partner's initiations, and partnered sexual activity, and how these associations were moderated by perceived partner support. Ninety-four cohabitating couples (M age = 26.30, SD = 7.60) provided six reports a day for 10 consecutive days. We used response surface analysis to examine the associations among both the degree and direction of (dis)similarity in partners' dyadic desire and each of the three outcome variables. Our results revealed that although partners tended to experience similar levels of desire on a moment-to-moment basis, similarity in desire levels was not associated with the three outcome variables. Rather, higher desire within couples predicted each partner's behavioral outcomes. At lower levels of perceived partner support, dyadic sexual desire was negatively associated with women's receptivity to sexual initiations by their partners, indicating high context-sensitivity of women's sexual responding. These findings offer new insights into the links between the similarity in partners' levels of dyadic desire and sexual behaviors in couples, suggesting the need for increased focus on maintaining desire and promoting perceived partner support in clinical practice.

Predictors and outcomes of sports coaches' athlete-invested contingent self-worth.

Some sports coaches not only invest considerable time and energy in their athletes, but also attach their self-worth to the successes and failures of their athletes. Grounded in Self-Determination Theory, the present study aimed to examine the theoretical predictors and outcomes of such Athlete-Invested Contingent Self-worth (AICS). Results from a cross-sectional study (Study 1; N = 740, Mage = 34.37 years) and an experimental vignette-based study among youth sports coaches (Study 2; N = 318, Mage = 38.94 years) indicated that AICS was positively related to a controlling coaching style and negatively related to a structuring style. Study 1 showed that a perceived evaluative club board was positively related to AICS, and Study 2 further demonstrated that poor performance was negatively associated with AICS and that an evaluative climate was related to AICS through experiences of need frustration. The discussion focuses on the pitfalls of coaches' contingent self-worth for the development of their athletes.

The Ghent Psychotherapy Study: A Pragmatic, Stratified, Randomized Parallel Trial into the Differential Efficacy of Psychodynamic and Cognitive-Behavioral Interventions in Dependent and Self-Critical Depressive Patients.

INTRODUCTION: Different types of psychotherapy are effective for treating major depressive disorder across groups yet show large within-group differences. Patient personality style is considered a potentially useful variable for treatment matching. OBJECTIVE: This study is the first experimental test of the interaction between therapeutic approach and patients' dependent versus self-critical personality styles. METHODS: A pragmatic stratified parallel trial was carried out with 100 adult patients diagnosed with DSM-IV-TR major depressive disorder. They were randomly assigned to short-term (16-20 sessions) cognitive behavioral therapy (CBT) or short-term psychodynamic psychotherapy (STPP). Patients were assessed at baseline, during therapy, post-therapy, and at 3- and 6-month follow-up. Primary outcome is depression severity measured by the Hamilton Rating Scale for Depression posttreatment. Primary analysis was by intention to treat. This trial is registered with the ISRCTN registry (www.isrctn.com), number ISRCTN17130982. RESULTS: The intention-to-treat sample consisted of 100 participants; 40 with self-critical and 60 with dependent personality styles were randomized to either CBT (n = 50) or STPP (n = 50). We observed no interaction effect (-0.34 [-6.14, 5.46]) between therapy and personality style and found no evidence for a difference in effectiveness between the treatments in general in terms of symptom reduction and maintained benefits at 6-month follow-up. CONCLUSION: We found no evidence that dependent versus self-critical personality styles moderate the relation between treatment and outcome in depression. Research using individual patient data could gain further insight into why specific therapeutic approaches work better for specific patients.

Daily Sexual Behavior, Sexual Esteem, and Body Image in Transgender and Cisgender Individuals.

Multiple surveys have suggested that transgender individuals show lower sexual well-being than cisgender individuals. Most studies, however, are limited in terms of ecological validity and memory bias and cross-sectional in nature. These issues are less prevalent in diary studies monitoring responses over time at home. For three weeks, 47 transgender (M age = 29.00, SD = 11.62) and 52 cisgender individuals (M age = 32.90, SD = 11.44) reported daily on their sexual behavior, sexual esteem and body image. Using multilevel model analyses, we investigated the daily associations between these variables, and addressed differences between transgender and cisgender individuals. We found that in transgender individuals, intimacy predicted sexual esteem; sexual openness predicted sexual esteem and body image; and sexual esteem predicts intimacy, masturbation, and sexual openness on the daily level. While transgender individuals scored lower on daily sexual esteem and body image than cisgender individuals, groups did not differ in daily sexual behavior. They also did not differ in any of the predictive relations described above, but we did find that the association between masturbation and body image was moderated by a cisgender identity, and sexual esteem predicted sexual activity more positively in cisgender compared to transgender individuals. These results complement findings from cross-sectional studies and indicate how transgender individuals struggling with sexuality can increase sexual openness. Implications for clinical practice are that clinicians discussing sexuality with their transgender patients should not define sexual activity too narrowly, and that sexual esteem might be a relevant factor in determining sexual behavior.

An examination of the reciprocal associations between physical activity and anxiety, depressive symptoms, and sleep quality during the first 9 weeks of the COVID-19 pandemic in Belgium.

During the initial outbreak of the global COVID-19 pandemic, many countries imposed a total lockdown (containment at home). Although it was still allowed in Belgium to be physically active or exercise with people from your household in the vicinity of your home, engaging in sports or physical activity in a group or club context was no longer permitted. To examine whether a lack of physical activity was potentially threatening to the mental well-being of citizens and vice versa, the present study examined concurrent and reciprocal relationships between physical activity and anxiety, depressive symptoms, and sleep quality during the COVID-19 lockdown in a 9-week longitudinal design. In a sample of 983 Belgian adults (75.1% female; M age = 43.78, range = 18-82 years), we explored these relationships at both the between- and within-person levels through random intercept cross-lagged panel models. The findings indicate that more physical activity was associated with lower symptoms of anxiety and depression and better sleep quality, a finding observed both at the between-person (across weeks; ßanxiety = -0.25, ßdepression = -0.30, ßsleep quality = 0.24, p < .001) and within-person level (within weeks; ßanxiety = -0.10, ßdepression = -0.14, ßsleep quality = 0.11, p < .05). Moreover, at the within-person level, an increase in feelings of anxiety and depression at one moment predicted lower levels of physical activity one week later (ßanxiety = -0.04, ßdepression = -0.06, p < .05). Since poor mental health poses a threat to the maintenance of physical activity, the current findings suggest that it is critical to invest in the mental health of individuals during distressing times.

When You Can't Play Sports: The Impact of the COVID-19 Pandemic on Motivational and Emotional Experiences in Coach-Athlete Dyads.

(1) Background: This study aimed to assess the influence of the COVID-19 pandemic on athletes' and coaches' experiences. Following the Dualistic Model of Passion and the Self-determination Theory, the objectives of this study were to investigate whether the COVID-19 pandemic and its restrictions affected athletes' and coaches' passion experiences, emotional experiences and basic psychological needs while engaging in their sport activities. Furthermore, the relationship between passion and emotional experiences as well as between passion and the basic psychological needs were explored; (2) Methods: 87 coach-athlete dyads, active at the recreational or competitive level in an individual sport, participated in the study. Using a cross-sectional dyadic design, athletes and coaches reported separately on their passion experience, emotional experiences and basic psychological needs in the previous two weeks; (3) Results: In total, 30 dyads were impacted by the COVID-19 pandemic, while 57 were not. Athletes' obsessive passion as well coaches' negative affect were larger in impacted dyads, while athletes' positive affect was lower in that group compared to the not-impacted group. Moderated Actor-Partner Interdependence Models revealed that coaches' obsessive passion was more strongly related to their negative affect in coach-athlete dyads that were not impacted by the COVID-19 pandemic than in dyads that were impacted. Furthermore, the harmonious passion of coaches was more strongly associated with athletes' need satisfaction and need frustration in impacted dyads, while also the athletes' harmonious passion in impacted dyads was more strongly associated with coaches' need satisfaction; (4) Conclusions: Less positive outcomes and more negative outcomes were observed in both athletes and coaches that were impacted by the COVID-19 pandemic. On the other hand, the COVID-19 pandemic may have suppressed the negative effects of coaches' obsessive passion on their negative affect, but strengthened the positive impact of coaches' harmonious passion on the athletes' need satisfaction and vice versa.

Dealing With Autocorrelation in the Single Case AB-Design: A Study Assessing the Mediating Effect of Infant Crying on the Relation Between Responsive Soothing and Infant Sleep.

Mediation analysis is widely adopted by researchers to disentangle the causal pathways by which an intervention affects an outcome. This paper describes a model to estimate the direct and indirect effect from a single subject AB-design with repeated assessments of both the mediator and the outcome. We discuss the plausibility of the modeling assumptions and contrast different approaches to deal with the autocorrelation in the time series data. While there are only small differences between those approaches when the number of timepoints is small (T = 15), the Generalized Least Squares approach performs best in medium (T = 30) to large (T = 90) time series. We apply the proposed methodology to data from a single case AB-design that was conducted with a mother of an excessively crying baby. Daily crying and baby sleep during the night were assessed with online diaries during a baseline phase and intervention phase. Between both phases, the pediatrician instructed the mother how to apply a responsive soothing intervention, the happiest baby (THB) method. We find that the direct effect of THB on sleeping is positive. THB also reduces crying but decreased crying during the day is associated with decreased sleeping during the night and hence a negative indirect effect of THB on sleeping via crying is found.

Nonlinear mediation analysis with high-dimensional mediators whose causal structure is unknown.

With multiple possible mediators on the causal pathway from a treatment to an outcome, we consider the problem of decomposing the effects along multiple possible causal path(s) through each distinct mediator. Under a path-specific effects framework, such fine-grained decompositions necessitate stringent assumptions, such as correctly specifying the causal structure among the mediators, and no unobserved confounding among the mediators. In contrast, interventional direct and indirect effects for multiple mediators can be identified under much weaker conditions, while providing scientifically relevant causal interpretations. Nonetheless, current estimation approaches require (correctly) specifying a model for the joint mediator distribution, which can be difficult when there is a high-dimensional set of possibly continuous and noncontinuous mediators. In this article, we avoid the need to model this distribution, by developing a definition of interventional effects previously suggested for longitudinal mediation. We propose a novel estimation strategy that uses nonparametric estimates of the (counterfactual) mediator distributions. Noncontinuous outcomes can be accommodated using nonlinear outcome models. Estimation proceeds via Monte Carlo integration. The procedure is illustrated using publicly available genomic data to assess the causal effect of a microRNA expression on the 3-month mortality of brain cancer patients that is potentially mediated by expression values of multiple genes.

Disentangling indirect effects through multiple mediators without assuming any causal structure among the mediators.

hen multiple mediators exist on the causal pathway from treatment to outcome, path analysis prevails for disentangling indirect effects along paths linking possibly several mediators. However, separately evaluating each indirect effect along different posited paths demands stringent assumptions, such as correctly specifying the mediators' causal structure, and no unobserved confounding among the mediators. These assumptions may be unfalsifiable in practice and, when they fail to hold, can result in misleading conclusions about the mediators. Nevertheless, these assumptions are avoidable when substantive interest is in inference about the indirect effects specific to each distinct mediator. In this article, we introduce a new definition of indirect effects called interventional indirect effects from the causal inference and epidemiology literature. Interventional indirect effects can be unbiasedly estimated without the assumptions above while retaining scientifically meaningful interpretations. We show that under a typical class of linear and additive mean models, estimators of interventional indirect effects adopt the same analytical form as prevalent product-of-coefficient estimators assuming a parallel mediator model. Prevalent estimators are therefore unbiased when estimating interventional indirect effects-even when there are unknown causal effects among the mediators-but require a different causal interpretation. When other mediators moderate the effect of each mediator on the outcome, and the mediators' covariance is affected by treatment, such an indirect effect due to the mediators' mutual dependence (on one another) cannot be attributed to any mediator alone. We exploit the proposed definitions of interventional indirect effects to develop novel estimators under such settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Practical Tool for Family Assessment Based on the Social Relations Model.

An empirically based family assessment can help family therapists understand how a family functions. In systemic therapy a family is seen as a dynamic system in which the family members form interdependent subsystems. The Social Relations Model (SRM) is a useful tool to study such interdependence within a family. According to the SRM, each dyadic score is viewed as the sum of an unobserved family effect, an individual actor and partner effect, and a relation-specific effect. If dyadic data are obtained for a specific family using a round robin design, these different SRM effects can be calculated using an ANOVA-approach. To gain insight into the functioning of a particular family, the family-specific SRM effects can be compared to those from a norm sample and it can be deduced whether that family has deviating scores on a particular SRM effect. Currently, such a family assessment relies on the mean and variance of the SRM ANOVA scores in the norm sample. However, family therapists may not always have access to these data, making the current approach of SRM family assessment not as useful in practice. In this article, we introduce a user-friendly web application that uses an alternative method for SRM family assessment. This alternative strategy requires as input the population parameter estimates of SRM means and variances more commonly described in SRM family literature.

Well-being and Perceived Stigma in Individuals With Rheumatoid Arthritis and Fibromyalgia: A Daily Diary Study.

INTRODUCTION: The presence or absence of clearly defined symptoms and underlying pathophysiology may be a crucial variable related to variability in well-being and stigmatization in individuals with chronic pain (ICPs). In the context of pain, absence of clearly defined symptoms and pathophysiology deviates from the widely endorsed biomedical model and as such, may lead to stigmatization, which in turn could be related to ICPs' well-being. OBJECTIVES: The present study compared physical, psychological, social well-being, and perceived stigmatization in individuals with clearly defined symptoms and underlying pathophysiology (rheumatoid arthritis, RA) and individuals with less well understood symptoms and pathophysiology (fibromyalgia, FM) using daily diaries. Furthermore, the association between daily perceived stigmatization and daily well-being was examined. MATERIALS AND METHODS: Seventy-nine participants with FM, 86 participants with RA, and 33 participants with both diagnoses completed a diary for 14 consecutive days. RESULTS: Compared to individuals with RA, individuals with FM and individuals with both diagnoses reported worse daily well-being. After controlling for age, pain duration, and daily pain, differences between FM and RA remained significant for social well-being and completion of plans. Differences between RA and the dual diagnosis group remained significant for completion of plans, negative affect, and isolation. Furthermore, results suggested more stigmatization in individuals with FM than in individuals with RA. Individuals with both diagnoses reported equal stigmatization as individuals with FM, but more stigmatization than individuals with RA. Finally, increased levels of perceived stigma were associated with lower well-being. DISCUSSION: Findings highlight that the absence of clearly defined symptoms and pathophysiology could be contributing to greater feelings of stigmatization, which may be detrimental for ICPs' well-being.

Which behaviour change techniques are effective to promote physical activity and reduce sedentary behaviour in adults: a factorial randomized trial of an e- and m-health intervention.

BACKGROUND: E- and m-health interventions are promising to change health behaviour. Many of these interventions use a large variety of behaviour change techniques (BCTs), but it's not known which BCTs or which combination of BCTs contribute to their efficacy. Therefore, this experimental study investigated the efficacy of three BCTs (i.e. action planning, coping planning and self-monitoring) and their combinations on physical activity (PA) and sedentary behaviour (SB) against a background set of other BCTs. METHODS: In a 2 (action planning: present vs absent) × 2 (coping planning: present vs absent) × 2 (self-monitoring: present vs absent) factorial trial, 473 adults from the general population used the self-regulation based e- and m-health intervention 'MyPlan2.0' for five weeks. All combinations of BCTs were considered, resulting in eight groups. Participants selected their preferred target behaviour, either PA (n = 335, age = 35.8, 28.1% men) or SB (n = 138, age = 37.8, 37.7% men), and were then randomly allocated to the experimental groups. Levels of PA (MVPA in minutes/week) or SB (total sedentary time in hours/day) were assessed at baseline and post-intervention using self-reported questionnaires. Linear mixed-effect models were fitted to assess the impact of the different combinations of the BCTs on PA and SB. RESULTS: First, overall efficacy of each BCT was examined. The delivery of self-monitoring increased PA (t = 2.735, p = 0.007) and reduced SB (t = - 2.573, p = 0.012) compared with no delivery of self-monitoring. Also, the delivery of coping planning increased PA (t = 2.302, p = 0.022) compared with no delivery of coping planning. Second, we investigated to what extent adding BCTs increased efficacy. Using the combination of the three BCTs was most effective to increase PA (x2 = 8849, p = 0.003) whereas the combination of action planning and self-monitoring was most effective to decrease SB (x2 = 3.918, p = 0.048). To increase PA, action planning was always more effective in combination with coping planning (x2 = 5.590, p = 0.014; x2 = 17.722, p < 0.001; x2 = 4.552, p = 0.033) compared with using action planning without coping planning. Of note, the use of action planning alone reduced PA compared with using coping planning alone (x2 = 4.389, p = 0.031) and self-monitoring alone (x2 = 8.858, p = 003), respectively. CONCLUSIONS: This study provides indications that different (combinations of) BCTs may be effective to promote PA and reduce SB. More experimental research to investigate the effectiveness of BCTs is needed, which can contribute to improved design and more effective e- and m-health interventions in the future. TRIAL REGISTRATION: This study was preregistered as a clinical trial (ID number: NCT03274271 ). Release date: 20 October 2017.

Reformulating and Mirroring in Psychotherapy: A Conversation Analytic Perspective.

The conversational actions of reformulating and mirroring constitute some of the core intervention techniques of psychotherapy. The purpose of the present study was to investigate the way in which therapists in cognitive-behavioral (CBT) and psychodynamic therapy (PDT) use reformulating and mirroring strategies to return patients' prior talk and how their differential usage can be viewed in light of the respective manualized recommendations. A mixed methods approach was applied using qualitative data that derived from a RCT. The data collection consisted of 200 excerpts assembled from both treatment conditions. The method of Conversation Analysis was used to determine the practices that accomplished instances of reformulating and mirroring, and to examine their distinct implications for subsequent talk. The quantitative analysis revealed that cognitive-behavioral therapists are significantly more likely to use reformulations, which is in harmony with what is suggested in CBT's treatment manuals. Psychodynamic therapists' frequent use of transformative formulations is, by contrast, unexpected in regard to the suggestions of the treatment protocol, as these interventions steer toward topical closure. Compared to the CBT condition, psychodynamic therapists were still significantly more likely to rely on mirroring strategies, which are in line with PDT's theoretical preference. Our findings raise the question whether alleged differences in treatment styles, as they are imposed by RCT methodology, are actually tangible in manual-guided clinical practice.

A Network Analysis of Potential Antecedents and Consequences of Pain-Related Activity Avoidance and Activity Engagement in Adolescents.

OBJECTIVE: This study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain. METHODS: Adolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor. RESULTS: Activity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement. CONCLUSIONS: This study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.

Estimation of Controlled Direct Effects in Longitudinal Mediation Analyses with Latent Variables in Randomized Studies.

In a randomized study with longitudinal data on a mediator and outcome, estimating the direct effect of treatment on the outcome at a particular time requires adjusting for confounding of the association between the outcome and all preceding instances of the mediator. When the confounders are themselves affected by treatment, standard regression adjustment is prone to severe bias. In contrast, G-estimation requires less stringent assumptions than path analysis using SEM to unbiasedly estimate the direct effect even in linear settings. In this article, we propose a G-estimation method to estimate the controlled direct effect of treatment on the outcome, by adapting existing G-estimation methods for time-varying treatments without mediators. The proposed method can accommodate continuous and noncontinuous mediators, and requires no models for the confounders. Unbiased estimation only requires correctly specifying a mean model for either the mediator or the outcome. The method is further extended to settings where the mediator or outcome, or both, are latent, and generalizes existing methods for single measurement occasions of the mediator and outcome to longitudinal data on the mediator and outcome. The methods are utilized to assess the effects of an intervention on physical activity that is possibly mediated by motivation to exercise in a randomized study.

A quest for self-soothing: A systematic case study into emotion-focused therapy with an emotionally avoidant client who committed sexual offenses.

OBJECTIVE: The current study is part of a multiple case study that investigated the emotional change in individuals who have committed sexual offenses (ISOs). This case study highlights how one client used sex as a maladaptive coping strategy to suppress negative emotions. METHOD: A mixed-methods design was used to track changes in the client's affect regulation (AR) during four phases, including a baseline (Phase A), treatment as usual (Phase B), treatment with an emotion-focused therapy (EFT) component added (Phase C), and follow up (Phase A). RESULTS: The qualitative description with verbatim clinical vignettes, revealed deeper insight into some important steps and hindrances and the impact of specific EFT-interventions. Quantitative analysis of self-report and observational measures showed a significant improvement in the client's AR across different phases of treatment. CONCLUSIONS: The study improves our knowledge of the emotional change in ISOs during treatment and illustrates some key interventions, steps, and hindrances.

Investigating How Parental Instructions and Protective Responses Mediate the Relationship Between Parental Psychological Flexibility and Pain-Related Behavior in Adolescents With Chronic Pain: A Daily Diary Study.

BACKGROUND: Parental behavior can influence how well adolescents cope with chronic pain. Previous research has largely focused on how parents negatively impact adolescent functioning. Yet more recent work suggests that parents - and particularly parental psychological flexibility - can foster better adolescent pain-related functioning. In this study we examined if parental protective responses and instructions to engage in activities in the presence of pain mediate the impact of parental psychological flexibility and acceptance of adolescent pain on adolescents' daily pain-related behavior. METHOD: Fifty-six adolescents with chronic pain (M age = 14.5 years, 86% girls) and one of their parents (93% mothers) were recruited at initial evaluation at two pediatric pain clinics in the US. Parents completed baseline questionnaires assessing psychologically flexible parenting and acceptance of adolescent pain. Next, parents and adolescents completed a 14-day self-report diary assessing adolescent activity-avoidance and activity-engagement in the presence of pain (adolescent report), and parental protective responses and instructions for their adolescent to engage in activities (parent report). RESULTS: Psychologically flexible parenting and acceptance of adolescent pain in parents were indirectly related to lower daily adolescent activity-avoidance, via their negative association with daily parental protective responses. Positive associations also emerged between baseline psychologically flexible parenting and overall levels of adolescent activity-engagement via its negative association with overall levels of parental protectiveness across the 14-day period. Psychologically flexible parenting and parental acceptance of adolescent pain were also indirectly related to daily decreases in adolescent activity-avoidance via their association with daily increases in parental activity-engagement instructions. These baseline parental resilience factors were also positively related to overall levels of parental engagement instructions, a route via which an indirect association with both higher overall activity-engagement as well as higher overall activity-avoidance in the adolescent was observed. CONCLUSION: Our findings suggest an (indirect) adaptive role of parental psychological flexibility on adolescent daily pain-related behavior via its impact on parental protective behavior. If our findings replicate, they would suggest that these parental behaviors could be targeted in pain treatments that include both adolescents and their parents. Future research could further examine the impact of parental instructions on pain-related behavior in adolescents with chronic pain.

Therapists' responses toward dependent (anaclitic) and self-critical (introjective) depressed outpatients: A multilevel approach.

Drawing on Blatt's theory about personality styles, we examined therapists' affective experiences toward depressed patients with dependent (anaclitic) and self-critical (introjective) personality styles. In addition, we investigated the relationship between therapists' responses, symptom severity, and therapeutic change. Therapists (N = 8) completed the Therapist Response Questionnaire (TRQ) at 5 time points for 50 dependent (anaclitic) and 34 self-critical (introjective) patients (N = 84) over the course of 20-session therapies. Consistent with our predictions, multilevel regression analyses showed that therapists experience stronger responses on the TRQ dimension "parental/protective" toward dependent (anaclitic) patients than toward self-critical (introjective) patients. However, we found no significant relationships between the personality styles and other TRQ dimensions. Furthermore, we found that cognitive-behavioral therapists reported stronger affective responses than psychodynamic therapists. No significant associations were found between the severity of patients' symptoms at the start of treatment and the general intensity of therapists' initial affective experiences, yet therapists experienced stronger emotional reactions when patients made no therapeutic progress. Although further in-depth research on the relationship between therapist responses and patients' personality styles is needed, this study provides partial evidence for Blatt's assertion that the two personality styles are relevant for understanding transference and countertransference processes in therapy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Couples Dealing With Pediatric Blood Cancer: A Study on the Role of Dyadic Coping.

Objective: Pediatric cancer is a life-threatening disease that poses significant challenges to the ill child and his/her parents. Among the studies investigating risk and protective factors for the individual and relationship adjustment of parents being confronted with pediatric cancer, couple factors - such as dyadic coping - gained little research attention. Therefore, the aim of the current study was to explore the association between dyadic coping and individual/relationship outcomes of parents in the context of pediatric cancer. Methods: Participants were 59 couples of children diagnosed with leukemia or Non-Hodgkin lymphoma. Time since diagnosis varied from diagnosis to 20 months. Both parents completed the DCI-short, DASS21, PIP, and MMQ. Results: Positive dyadic coping (i.e., supportive and common dyadic coping) and negative dyadic coping proved to be related to individual and relational outcomes of parents facing cancer in their child. In addition, while men and women reported to be equally satisfied with their partner and their sexual relationship, women reported higher levels of individual maladjustment. Conclusion: Our findings led to the conclusion that dyadic coping is important for both individual as well as relationship outcomes of parents when facing a diagnosis of cancer in their child. When meeting with families, both partners should be invited as a unit in order to best capture couple level experiences. Also, clinicians should be sensitive to relational and sexual issues besides individual issues, taking into account evidence-based standards for psychosocial care in pediatric oncology.

A bootstrap version of the Hausman test to assess the impact of cluster-level endogeneity beyond the random intercept model.

In the random intercept model for clustered data, the random effect is typically assumed to be independent of predictors. Violation of this assumption due to unmeasured cluster-level confounding (endogeneity) induces bias in the estimates of effects of within-cluster predictors. Treating cluster-specific intercepts as fixed rather than random avoids this bias. The Hausman test contrasts the fixed effect estimator with the traditional random effect estimator in the random intercept model to test for the presence of cluster-level endogeneity and has a known asymptotic χ2 -distribution under correct model specification. Unmeasured cluster-level heterogeneity may, however, interact with predictors as well, necessitating random slope models. Relying on either cluster or residual resampling in a bootstrap procedure, we propose two extensions of the Hausman test that can easily be used beyond the random intercept model. We compare the original Hausman test and its robust version to the newly proposed bootstrap tests in terms of empirical type I error rate and power. Under additive unmeasured heterogeneity, all methods perform equally well, whereas the original and robust Hausman tests are too liberal or too conservative under additional slope heterogeneity, both bootstrap Hausman tests maintain appropriate performance. Moreover, both bootstrap tests show robustness against misspecification in the presence of unit-level heteroscedasticity and temporal correlation.