"People don't understand what goes on in here": A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care.

BACKGROUND: The age demographic of the incarcerated is quickly shifting from young to old. Correctional facilities are responsible for navigating inmate access to healthcare; currently, there is no standardization for access to end-of-life care. There is growing research support for prison-based end-of-life care programs that incorporate inmate peer caregivers as a way to meet the needs of the elderly and dying who are incarcerated. AIM: This project aims to (a) describe a prison-based end-of-life program utilizing inmate peer caregivers, (b) identify inmate-caregiver motivations for participation, and (c) analyze the role of building trust and meaningful relationships within the correctional end-of-life care setting. DESIGN: A total of 22 semi-structured interviews were conducted with inmate-caregivers. Data were analyzed using Consensual Qualitative Research methodology. SETTING/PARTICIPANTS: All inmate-caregivers currently participating in the end-of-life peer care program at Briarcliff Correctional Facility were given the opportunity to participate. All participants were male, over the age of 18, and also incarcerated at Briarcliff Correctional Facility, a maximum security, state-level correctional facility. RESULTS: In total, five over-arching and distinct domains emerged; this manuscript focuses on the following three: (a) program description, (b) motivation, and (c) connections with others. CONCLUSION: Findings suggest that inmate-caregivers believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative to work toward greater standardization of and access to end-of-life care for the incarcerated.

A consensual qualitative research analysis of the experience of inmate hospice caregivers: Posttraumatic growth while incarcerated.

A growing number of correctional facilities train inmates to provide end-of-life care for dying inmates. This study explores the phenomenological perspective of inmate-caregivers participating in an inmate-facilitated hospice program (IFHP) with regard to meaning and purpose in life, attitudes on death and dying, and perceived personal impact of participation. Twenty-two inmate-caregivers were interviewed at a maximum-security state correctional facility in the United States. The interviews were transcribed verbatim and analyzed using the Consensual Qualitative Research Methodology. Results suggest that participating in an IFHP may facilitate personal growth and transformation that mirrors the tenets of posttraumatic growth.

The Incremental Validity of Narrative Identity in Predicting Well-Being: A Review of the Field and Recommendations for the Future.

Grounded in four theoretical positions-structural, cognitive, phenomenological, and ethical-the present review demonstrates the empirical evidence for the incremental validity of narrative identity as a cross-sectional indicator and prospective predictor of well-being, compared with other individual difference and situational variables. In doing so, we develop an organizational framework of four categories of narrative variables: (a) motivational themes, (b) affective themes, (c) themes of integrative meaning, and (d) structural elements. Using this framework, we detail empirical evidence supporting the incremental association between narrative identity and well-being, a case that is strongest for motivational, affective, and integrative meaning themes. These categories of themes serve as vital complimentary correlates and predictors of well-being, alongside commonly assessed variables such as dispositional personality traits. We then use the theoretically grounded review of the empirical literature to develop concrete areas of future research for the field.

The impact of sustained engagement on cognitive function in older adults: the Synapse Project.

In the research reported here, we tested the hypothesis that sustained engagement in learning new skills that activated working memory, episodic memory, and reasoning over a period of 3 months would enhance cognitive function in older adults. In three conditions with high cognitive demands, participants learned to quilt, learned digital photography, or engaged in both activities for an average of 16.51 hr a week for 3 months. Results at posttest indicated that episodic memory was enhanced in these productive-engagement conditions relative to receptive-engagement conditions, in which participants either engaged in nonintellectual activities with a social group or performed low-demand cognitive tasks with no social contact. The findings suggest that sustained engagement in cognitively demanding, novel activities enhances memory function in older adulthood, but, somewhat surprisingly, we found limited cognitive benefits of sustained engagement in social activities.

Longitudinal Follow-Up Study of Social Intervention Outcomes for Children on the Autism Spectrum.

A prior randomized trial found a school social intervention yielded significantly better outcomes (social and autism features) immediately following intervention compared to typical school programming (services-as-usual [SAU]) for children on the autism spectrum. In that study, children in the SAU condition subsequently completed a summer social intervention. This study tested longer-term maintenance of effects for children who completed both interventions. A total of 103 children (ages 6-12 years) on the autism spectrum enrolled and 102 completed the initial RCT. Following the summer social intervention, 90 children from the original RCT completed the longer-term follow-up study. In addition to baseline and posttest in the initial RCT, children from both groups were tested at three follow-up points (five total testing points). At the time of first longitudinal follow-up testing, the children were 1.25-4.25 years post-intervention (ages 8-15 years). Longitudinal multilevel model analyses (and follow-up contrasts) revealed significant improvements for both groups post-intervention on measures of emotion recognition, autism features, and social skills, indicating maintenance of post-intervention improvements over the three follow-up testing points. No between-group differences were found for autism features or social skills over time; however, the school social intervention may have yielded somewhat better emotion recognition skills. Exploratory tests found that child IQ, language level, and length of time since completing the intervention did not moderate outcomes. Both social interventions yielded positive and durable longer-term improvements for children on the autism spectrum. [ClinicalTrials.gov, NCT03338530; November 8, 2017; original retrospectively registered trial].

Effect of COVID-19 Stay-at-Home Restrictions on Parent Reported Symptom Severity and Adaptive Functioning of Youth with ASD.

This study assessed the potential short-term effects of COVID-19 stay-at-home restrictions on ratings of ASD and comorbid symptoms severity and adaptive functioning of 69 youth, ages 8-16 years with ASD without intellectual disability. Parent/caregiver ratings were being collected in fall and spring over approximately two years when the restrictions were imposed four months prior to the final data collection point. Results indicated no significant changes in parent/caregiver ratings of ASD symptom severity, comorbid symptoms severity, social skills, or adaptive behaviors following the stay-at-home restrictions and little variability across the four data collection points. Although findings suggested minimal short-term effects on these symptoms and adaptive skills, ongoing monitoring is needed to assess longer-term impacts.

Implications of identity resolution in emerging adulthood for intimacy, generativity, and integrity across the adult lifespan.

Erikson's psychosocial stage model posits that identity formation is a key developmental task for adolescents, and that successfully resolving the identity versus role confusion crisis at this time of life has important impacts on psychosocial development through adulthood. However, little empirical work has tested the consequences of early-life identity development for progression through the subsequent psychosocial stages in Erikson's model. The purpose of the present study was to test whether identity resolution measured during emerging adulthood predicted later developmental trajectories of intimacy, generativity, and integrity across adulthood. We used data from four cohorts of participants in the Rochester Adult Longitudinal Study (RALS; N = 1,224), with up to five assessments spanning the twenties through the sixties. Latent growth curve modeling was used to estimate developmental trajectories for intimacy, generativity, and integrity, and to test the association between emerging adulthood identity resolution and growth parameters for each psychosocial outcome. Findings suggested that individuals with higher emerging adulthood identity resolution also experienced high levels of intimacy, generativity, and integrity in emerging adulthood, and these levels remained consistently high across adulthood. In contrast, those with lower identity resolution in emerging adulthood experienced lower initial levels of intimacy, generativity, and integrity, but faster growth over time. As a result, these trajectories appeared to nearly converge by the time participants were in their sixties, suggesting that one's emerging adulthood identity has less importance over time, and that individuals who struggled more with identity formation in adolescence and emerging adulthood are able to make up for it later in life. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The codevelopment of generativity and well-being into early late life.

The current manuscript replicates and extends the few existing studies of generativity in later adulthood with regard to two aims: (a) to model individual differences in the development of generativity into early late life and (b) to examine the relationship between development in generativity and development in well-being into late midlife and early late life. Data from the Rochester Adult Longitudinal Study (RALS) are used to address these aims in a preregistered secondary analysis of existing RALS data (see https://osf.io/syp2u). Analyses quantify individual development of generativity in a sample of 271 RALS participants who completed the Loyola Generativity Scale (LGS; McAdams & de St. Aubin, Journal of Personality and Social Psychology, 1992, 62, p. 1003) and the Psychological Well-Being Scale (PWB; Ryff, Journal of Personality and Social Psychology, 1989a, 57, p. 1069) during the most recent two waves of the RALS (2000-2012). Generativity demonstrated substantial rank-order stability but no mean-level change. There was substantial variability in both stability and change. Dual score change models showed a robust concurrent relationship between generativity and well-being at the first assessment and meaningful correlated change over time. While demographic and social role covariates were not associated with study findings, one of the most important limitations of the RALS is the racial and ethnic homogeneity of the sample, which constrains generalizability and potentially may restrict the range of these variables. Results are discussed in the context of our current understanding of the development and impact of generativity in later adulthood, and directions for future research in this area are identified. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Relationship Between Career Success and Sense of Purpose: Examining Linkages and Changes.

OBJECTIVES: Although researchers have linked sense of purpose to working status, there are few studies examining how specific characteristics of work may correlate with sense of purpose. The aim of the current study is to extend prior research by assessing the degree to which objective and subjective forms of career success-occupational prestige and work satisfaction-are associated with levels of and changes in sense of purpose. METHODS: Participants were part of the Rochester Adult Longitudinal Study (N = 307), which contains multiple cohorts of participants each assessed at multiple waves (full age range: 42-71). We used cross-lagged modeling to test the relationships in our model. RESULTS: Occupational prestige was not associated with sense of purpose levels and change. However, work satisfaction was positively associated with higher levels of sense of purpose initially, and there was evidence that changes in the 2 constructs were positively correlated. DISCUSSION: These findings suggest that subjective career success may be more important for sense of purpose than more objective indicators. Findings are discussed with respect to study limitations and guidance for future researchers using secondary data.

Psychometric properties of the Cambridge-Mindreading Face-Voice Battery for Children in children with ASD.

This study examined the psychometric characteristics of the Cambridge-Mindreading Face-Voice Battery for Children (CAM-C) for a sample of 333 children, ages 6-12 years with ASD (with no intellectual disability). Internal consistency was very good for the Total score (0.81 for both Faces and Voices) and respectable for the Complex emotions score (0.72 for Faces and 0.74 for Voices); however, internal consistency was lower for Simple emotions (0.65 for Faces and 0.61 for Voices). Test-retest reliability at 18 and 36 weeks was very good for the faces and voices total (0.76-0.81) and good for simple and complex faces and voices (0.53-0.75). Significant correlations were found between CAM-C Faces and scores on another measure of face-emotion recognition (Diagnostic Analysis of Nonverbal Accuracy-Second Edition), and between Faces and Voices scores and child age, IQ (except perceptual IQ and Simple Voice emotions), and language ability. Parent-reported ASD symptom severity and the Emotion Recognition scale on the SRS-2 were not related to CAM-C scores. Suggestions for future studies and further development of the CAM-C are provided. LAY SUMMARY: Facial and vocal emotion recognition are important for social interaction and have been identified as a challenge for individuals with autism spectrum disorder. Emotion recognition is an area frequently targeted by interventions. This study evaluated a measure of emotion recognition (the CAM-C) for its consistency and validity in a large sample of children with autism. The study found the CAM-C showed many strengths needed to accurately measure the change in emotion recognition during intervention.

Autism Characteristics and Self-Reported Health in Older Adulthood.

OBJECTIVES: The present research used a continuous measurement approach to extend the evidence that autism is associated with significant struggles in physical health as well as mental health and psychological well-being. METHODS: The relationship of autism characteristics to physical health and psychological well-being was examined in 294 individuals (M age = 70.51, SD age = 8.17, age range = 53-96). The sample is 57.4% female (n = 166) and primarily White (n = 270, 96.8%). The majority of the participants did not identify as having an autism diagnosis (n = 284, 96.6%). Participants completed the Autism-Spectrum Quotient Scale alongside self-report measures of physical health, mental health, and psychological well-being. RESULTS: Autism characteristics correlated strongly with challenges in social engagement due to poor health (r = 0.46), depression (r = 0.39) and anxiety (r = 0.47), limitations due to poor mental health (r = 0.41), satisfaction with life (r = -0.47), and psychological well-being (r = -0.62). DISCUSSION: These findings help shed light on the challenges experienced by individuals aging with elevated autism characteristics. The limitations of this study and prior work on this topic help identify important avenues for future research in this area.

The Relationship of Age with the Autism-Spectrum Quotient Scale in a Large Sample of Adults.

Background: The historical focus on autism as a childhood disorder means that evidence regarding autism in adulthood lags significantly behind research in other age groups. Emerging studies on the relationship of age with autism characteristics do not target older adult samples, which presents a barrier to studying the important variability that exists in life span developmental research. This study aims to further our understanding of the relationship between the Autism-Spectrum Quotient Scale and age in a large adult sample. Methods: The present study examines the relationship of Autism-Spectrum Quotient Scale (AQ) scores with age in 1139 adults, ages 18-97 years. Participants came from three distinct samples-a sample of primarily students, a sample of MTurk participants, and a sample of primarily community dwelling older adults. The majority of the participants did not self-report an autism diagnosis (91%), were female (67%), and identified as White (81%). Participants completed the AQ primarily via online surveys. Researchers scored the AQ following six common scoring practices. Results: Results of preregistered analyses indicate that autism characteristics measured by the AQ are not strongly associated with age (r values from -0.01 to -0.11). Further findings indicate that the measurement of autism characteristics is consistent across age into late life using both multiple groups and local structural equation modeling approaches to measurement invariance (comparative fit indices = 0.82-0.83, root mean square error = 0.06) as well as reliability analysis. Finally, demographic and autism-related variables (sex, race, self-identified autism spectrum disorder diagnosis, and degree of autism characteristics) did not moderate the relationship between age and autism characteristics. Conclusion: These results suggest that self-reports of autism characteristics using the AQ do not vary strongly by age in this large age-representative sample. Findings suggest that the AQ can potentially serve as a useful tool for future research on autism across the life span. Important limitations on what we can learn from these findings point toward critical avenues for future research in this area. LAY SUMMARY: Why was this study done?: Self-report questionnaires of autism characteristics are a potentially important resource for studying autism in adulthood. This study sought to provide additional information about one of the most commonly used self-report questionnaires, the Autism-Spectrum Quotient Scale (AQ), across adulthood.What was the purpose of this study?: This study intended to determine if there is a relationship between scores on the AQ and age. Researchers also worked to identify which of the multiple different ways of scoring the AQ worked best across adulthood.What did the researchers do?: Researchers collected data from over a thousand participants aged 18-97 years. Participants from three different age groups completed online surveys to self-report their levels of autism characteristics on the AQ. Researchers tested the relationship between AQ scores and age with six different commonly used ways to calculate AQ scores. Researchers used multiple statistical techniques to evaluate various measurement properties of the AQ.What were the results of the study?: The results indicate that autism characteristics measured by the AQ are not strongly associated with age. Along with that, there is evidence that certain approaches to measuring of autism characteristics are consistent across age into late life and do not vary with demographic and autism-related factors.What do these findings add to what was already known?: These results add to the growing evidence that self-reports of autism characteristics using the AQ in general samples are not strongly associated with age across adulthood. These findings also provide guidance about ways of scoring the AQ that work well through late life.What are potential weaknesses in the study?: While the AQ has a degree of relationship with autism diagnoses, this is far from perfect and has not been evaluated in the context of aging research. Therefore, findings from the present research must be carefully interpreted to be about autism characteristics not diagnoses. The sample was also limited in a number of other ways. As in any studies including a broad age range of individuals, the oldest participants are likely quite healthy, engaged individuals. This may particularly be the case given the higher mortality rates and health challenges seen with autism. Similarly, as with any self-report research, this research is limited to those individuals who could answer questions about their autism characteristics. The sample was also predominantly White and nonautistic. Finally, the research was limited to one point in time and so cannot tell us about how autism characteristics may change across adulthood.How will these findings help autistic adults now or in the future?: These findings support the potential for the AQ to be a useful tool for future research on autism in adulthood. For example, researchers can use measures such as the AQ to study how autism characteristics change over time or are associated with aging-related issues such as changes in physical health and memory. Such research may be able to provide a better understanding of how to support autistic individuals across adulthood.

Getting to know me: social role experiences and age differences in self-concept clarity during adulthood.

The current research had 2 aims: (1) to determine the cross-sectional age differences in self-concept clarity during adulthood and (2) to examine the importance of social role experiences for age differences in self-concept clarity. These aims were addressed in 2 large samples of adults ranging in age from 18 to 94 years. In both studies, self-concept clarity had a curvilinear relation to age such that self-concept clarity was positively related to age from young adulthood through middle age and negatively related to age in older adulthood. This relationship was moderated by annual income and community investment. In addition, annual income and health-related social role limitations mediated age differences in self-concept clarity. Findings are discussed in terms of modern theories of identity development.

Moderators of School Intervention Outcomes for Children with Autism Spectrum Disorder.

A prior cluster randomized controlled trial (RCT) compared outcomes for a comprehensive school intervention (schoolMAX) to typical educational programming (services-as-usual [SAU]) for 103 children with autism spectrum disorder (ASD) without intellectual disability. The schoolMAX intervention was superior to SAU in improving social-cognitive understanding (emotion-recognition), social/social-communication skills, and ASD-related impairment (symptoms). In the current study, a range of demographic, clinical, and school variables were tested as potential moderators of treatment outcomes from the prior RCT. Moderation effects were not evident in demographics, child IQ, language, or ASD diagnostic symptoms, or school SES. Baseline externalizing symptoms moderated the outcome of social-cognitive understanding and adaptive skills moderated the outcome of ASD-related symptoms (no other comorbid symptoms or adaptive skills ratings moderated outcomes on the three measures). Overall, findings suggest that the main effects of treatment were, with two exceptions, unaffected by third variables.

The empirical structure of narrative identity: The initial Big Three.

A robust empirical literature suggests that individual differences in the thematic and structural aspects of life narratives are associated with and predictive of psychological well-being. However, 1 limitation of the current field is the multitude of ways of capturing these narrative features, with little attention to overarching dimensions or latent factors of narrative that are responsible for these associations with well-being. In the present study we uncovered a reliable structure that accommodates commonly studied features of life narratives in a large-scale, multi-university collaborative effort. Across 3 large samples of emerging and midlife adults responding to various narrative prompts (N = 855 participants, N = 2,565 narratives), we found support for 3 factors of life narratives: motivational and affective themes, autobiographical reasoning, and structural aspects. We also identified a "functional" model of these 3 factors that reveals a reduced set of narrative features that adequately captures each factor. Additionally, motivational and affective themes was the factor most reliably related to well-being. Finally, associations with personality traits were variable by narrative prompt. Overall, the present findings provide a comprehensive and robust model for understanding the empirical structure of narrative identity as it relates to well-being, which offers meaningful theoretical contributions to the literature, and facilitates practical decision making for researchers endeavoring to capture and quantify life narratives. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Narrating personality change.

The present research investigated the longitudinal relations between personality traits and narratives. Specifically, the authors examined how individual differences in 170 college students' narratives of personality change (a) were predicted by personality traits at the beginning of college, (b) related to actual changes and perceived changes in personality traits during college, and (c) related to changes in emotional health during college. Individual differences in narratives of personality trait change told in the 4th year of college fell into 2 dimensions: affective processing, characterized by positive emotions, and exploratory processing, characterized by meaning making and causal processing. Conscientious, open, and extraverted freshmen told exploratory stories of change as seniors. Emotionally healthy freshmen told stories of change that were high in positive affect. Both positive affective and exploratory stories corresponded to change in emotional stability and conscientiousness during college above and beyond the effects of perceived changes in these traits. In addition, both positive affective and exploratory narratives corresponded to increases in emotional health during college independent of the effects of changes in personality traits. These findings improve our understanding of how individuals conceptualize their changing identity over time.

Not all conscientiousness scales change alike: a multimethod, multisample study of age differences in the facets of conscientiousness.

Previous research has shown that traits from the domain of conscientiousness tend to increase with age. However, previous research has not tested whether all aspects of conscientiousness change with age. The present research tests age differences in multiple facets of conscientiousness (industriousness, orderliness, impulse control, reliability, and conventionality) using multiple methods and multiple samples. In a community sample (N = 274) and a representative statewide sample (N = 613) of 18- to 94-year-olds, self-reported industriousness, impulse control, and reliability showed age differences from early adulthood to middle age, whereas orderliness did not. The transition into late adulthood was characterized by increases in impulse control, reliability, and conventionality. In contrast, age differences in observer-rated personality occurred mainly in older adulthood. Age differences held across both ethnicity and levels of socioeconomic status.

Meta-analysis of Big Five personality traits in autism spectrum disorder.

The present meta-analysis synthesizes the emerging literature on the relationship of Big Five personality traits to autism spectrum disorder. Studies were included if they (1) either (a) measured autism spectrum disorder characteristics using a metric that yielded a single score quantification of the magnitude of autism spectrum disorder characteristics and/or (b) studied individuals with an autism spectrum disorder diagnosis compared to individuals without an autism spectrum disorder diagnosis and (2) measured Big Five traits in the same sample or samples. Fourteen reviewed studies include both correlational analyses and group comparisons. Eighteen effect sizes per Big Five trait were used to calculate two overall effect sizes per trait. Meta-analytic effects were calculated using random effects models. Twelve effects (per trait) from nine studies reporting correlations yielded a negative association between each Big Five personality trait and autism spectrum disorder characteristics (Fisher's z ranged from -.21 (conscientiousness) to -.50 (extraversion)). Six group contrasts (per trait) from six studies comparing individuals diagnosed with autism spectrum disorder to neurotypical individuals were also substantial (Hedges' g ranged from -.88 (conscientiousness) to -1.42 (extraversion)). The potential impact of personality on important life outcomes and new directions for future research on personality in autism spectrum disorder are discussed in light of results.

Brief Report: Examination of Sex-Based Differences in ASD Symptom Severity Among High-Functioning Children with ASD Using the SRS-2.

Prior studies of sex-based differences in autism spectrum disorder (ASD) have yielded mixed findings. This study examined ASD symptom severity and functional correlates in a sample of 34 high-functioning females with ASD (HFASD; M age = 8.93; M IQ = 104.64) compared to 34 matched males (M age = 8.96; M IQ = 104.44) using the Social Responsiveness Scale-Second Edition (SRS-2). Results identified non-significant and minimal differences (negligible-to-small) on the SRS-2 total, DSM-5 symptom subscale, and treatment subscale scores. Significant negative (moderate) correlations were found between the SRS-2 Social Cognition subscale and IQ and language scores and between the SRS-2 Social Motivation subscale and receptive language scores for females only; no significant correlations were found for males.

Social-class differences in self-concept clarity and their implications for well-being.

A consistent/stable sense of the self is more valued in middle-class contexts than working-class contexts; hence, we predicted that middle-class individuals would have higher self-concept clarity than working-class individuals. It is further expected that self-concept clarity would be more important to one's well-being among middle-class individuals than among working-class individuals. Supporting these predictions, self-concept clarity was positively associated with higher social class. Moreover, although self-concept clarity was associated with higher life satisfaction and better mental health, the association significantly attenuated among working-class individuals. In addition, self-concept clarity was not associated with physical health and its association with physical health did not interact with social class.