Psychobiographies of social change agents: Introduction to the Special Issue.

This Special Issue of Journal of Personality, focused on psychobiographies of social change agents, aims to make contributions to the field in terms of content, method, and process. The content of the issue is focused on understanding people who powerfully impact their world, from eminent global leaders to everyday change agents. The contributions to the Special Issue are unified by their adoption of psychobiographical methods, though as a set they offer both excellent representations of common psychobiographical approaches as well as vital innovations in this tradition. The process of curating this Special Issue sought to make several interventions in typical practices, including the cultivation of an intentional community of scholars representing both experienced and fledgling psychobiographers, the pursuit of a relational approach to publishing, and the adoption of open science practices. Psychobiography has an important role to play in contemporary personality psychology and we hope this Special Issue will itself serve as a foundation for continued innovation in the field.

Identity integration in people with acquired disabilities: A qualitative study.

OBJECTIVE: This qualitative investigation focused on identity integration in a sample of individuals who acquired physical disabilities in adulthood. It also argues for the importance and ethics of these methods in the broader field of scholarship on personality change following adversity. METHOD: Thirteen adults participated in the study. Participants engaged in an expanded Life Story Interview wherein they narrated the story of their life, including a section devoted to their story of acquiring a physical disability. In addition, participants completed questionnaires concerning their psychological well-being and maturity. RESULTS: We identified two dimensions of narrative themes participants used in grappling with identity integration: one represented active processing of one's life experiences and the other represented the extent to which participants described their identity as wholly transformed by the experience of acquiring a disability. When overlaid, these dimensions yielded four narrative strategies titled: Adapters, Wanderers, Drifters, and Resisters. We also observed that Adapters seemed to have better psychological well-being and maturity than the other groups. CONCLUSIONS: This study offers a foundation for future scholarship on identity among people with disabilities. It also describes the contexts in which retrospective, qualitative methods are especially appropriate for research on personality change following adversity.

Narrative Identity and Personality Disorder: an Empirical and Conceptual Review.

PURPOSE OF REVIEW: Identity is one of the key domains that is disturbed in people manifesting personality disorder (PD). Within the field of personality psychology, there is a robust approach to studying identity focused on narrative identity which has been largely overlooked in studying PD. In this paper, a systematic review was conducted of studies published in the past decade that focused on how individuals manifesting personality pathology craft their narrative identity. RECENT FINDINGS: This review revealed disturbances related to several motivational/affective themes (e.g., negative valence/valence shifts and thwarted themes of agency and communion), autobiographical reasoning (negative self-inferences), and structural elements (e.g., low coherence and fewer life script events) within the narrative identity of people who manifest PD. Narrative identity is disturbed in people experiencing personality pathology and may have crucial implications for enhancing our conceptual understanding of PD and for PD interventions. This review also points to several research limitations and gaps that we encourage the field to pursue in the future.

Managing haematology and oncology patients during the COVID-19 pandemic: interim consensus guidance.

INTRODUCTION: A pandemic coronavirus, SARS-CoV-2, causes COVID-19, a potentially life-threatening respiratory disease. Patients with cancer may have compromised immunity due to their malignancy and/or treatment, and may be at elevated risk of severe COVID-19. Community transmission of COVID-19 could overwhelm health care services, compromising delivery of cancer care. This interim consensus guidance provides advice for clinicians managing patients with cancer during the pandemic. MAIN RECOMMENDATIONS: During the COVID-19 pandemic: In patients with cancer with fever and/or respiratory symptoms, consider causes in addition to COVID-19, including other infections and therapy-related pneumonitis. For suspected or confirmed COVID-19, discuss temporary cessation of cancer therapy with a relevant specialist. Provide information on COVID-19 for patients and carers. Adopt measures within cancer centres to reduce risk of nosocomial SARS-CoV-2 acquisition; support population-wide social distancing; reduce demand on acute services; ensure adequate staffing; and provide culturally safe care. Measures should be equitable, transparent and proportionate to the COVID-19 threat. Consider the risks and benefits of modifying cancer therapies due to COVID-19. Communicate treatment modifications, and review once health service capacity allows. Consider potential impacts of COVID-19 on the blood supply and availability of stem cell donors. Discuss and document goals of care, and involve palliative care services in contingency planning. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT: This interim consensus guidance provides a framework for clinicians managing patients with cancer during the COVID-19 pandemic. In view of the rapidly changing situation, clinicians must also monitor national, state, local and institutional policies, which will take precedence. ENDORSED BY: Australasian Leukaemia and Lymphoma Group; Australasian Lung Cancer Trials Group; Australian and New Zealand Children's Haematology/Oncology Group; Australia and New Zealand Society of Palliative Medicine; Australasian Society for Infectious Diseases; Bone Marrow Transplantation Society of Australia and New Zealand; Cancer Council Australia; Cancer Nurses Society of Australia; Cancer Society of New Zealand; Clinical Oncology Society of Australia; Haematology Society of Australia and New Zealand; National Centre for Infections in Cancer; New Zealand Cancer Control Agency; New Zealand Society for Oncology; and Palliative Care Australia.

Stress resilience: Narrative identity may buffer the longitudinal effects of chronic caregiving stress on mental health and telomere shortening.

BACKGROUND: Chronic caregiving stress may accelerate biological aging; however, the ability to integrate the meaning of caregiving through self-awareness, adaptation, and growth can buffer the negative effects of stress. Narrative researchers have shown that people who coherently integrate difficult experiences into their life story tend to have better mental health, but no prior study has examined the prospective association between narrative identity and biological indicators, such as telomere length. We tested whether narrative identity might be prospectively associated with resilience to long-term parenting stress, depressive symptoms, and protection from telomere shortening, especially among caregivers. METHODS: We conducted a semi-structured interview about parenting and quantified narrative themes by applying well-validated, standardized coding systems with high inter-rater reliability among 88 mothers: 32 "caregivers" (mothers with a child diagnosed with an autism spectrum disorder), and 56 "controls" (mothers with a neurotypical child). To assess longitudinal changes, we measured mental health (parenting stress [PS], depressive symptoms [DS]) and leukocyte telomere length [LTL], a biomarker of aging, at baseline and again 18 months later. We examined whether narrative identity themes were related to these outcomes and whether associations differed across caregivers versus controls. RESULTS: Caregivers exhibited significantly higher basal levels of PS and DS relative to controls (all p's < .05), but no significant difference in LTL (p > .05). Caregivers rated higher in the narrative theme of integration showed healthier future 18-month trajectories in PS (B = -0.832, 99% CI: [-1.315, -0.155], p < .01) and LTL (B = 1.193, 99% CI: [0.526, 2.130], p < .01), but no differences in depressive symptoms (p > .05), adjusting for age and antidepressant use. Analyses examining affective themes in caregiver narratives did not demonstrate significant associations. Narrative themes did not predict outcomes in controls. CONCLUSIONS: The data suggest that narratives reflecting coherent integration, but not necessarily affect, prospectively relate to psychological and biological stress resilience. Maternal caregivers' ability to tell an integrated story of their parenting experiences forecasts lower parenting stress and telomere shortening over time. This study suggests the possibility that helping individuals better integrate the meaning of stressful experiences, but not necessarily to affectively redeem them, may constitute a potential novel target for intervention among chronically stressed populations such as caregivers.

Bringing the (disabled) body to personality psychology: A case study of Samantha.

OBJECTIVE: Personality psychology has largely ignored the experiences of people with disabilities. This article strives to bring the thriving, interdisciplinary field of disability studies to personality psychology via a case study of Samantha (N = 1). Samantha feels that she grew up as a hearing person who could not hear and is now a deaf person who can hear. METHOD: Narrative identity provides the theoretical, methodological, and analytical framework for the rich, qualitative examination of Samantha's life story, interwoven with approaches from disability studies and intersectionality theory. Two Life Story Interviews (McAdams, 2008), conducted 2 weeks prior to Samantha's cochlear implant surgery and again 7 weeks after the surgery, provide the foundation for this case study and are interpreted alongside additional self-report measures. Grounded theory methods were used to interpret Samantha's narrative identity. RESULTS: Samantha's story demonstrates the ways in which narrative identity can serve as a foundation for meaning and psychological well-being, as well as a demonstration of the ways in which the study of identity can be enriched by perspectives from disability studies. CONCLUSIONS: As an initial effort at integrating personality psychology and disability studies, this article sought to approach this task by privileging ethical representation over generalizability.

Personality Constructs and Paradigms in the Alternative DSM-5 Model of Personality Disorder.

The DSM-5 Section III alternative model for personality disorders (AMPD) is a personality disorder (PD) nosology based on severity of personality dysfunction and pathological traits. We examined the degree to which the personality constructs identified by McAdams and Pals (2006; dispositional traits, characteristic adaptations, narrative identity) and the paradigms of personality assessment described by Wiggins (2003; psychodynamic, interpersonal, personological, multivariate, empirical) are represented within the AMPD. Nine raters expert with the AMPD and personality evaluated elements of Criterion A and the 25 trait facets of Criterion B for presence of type and degree of personality constructs and paradigms, as well as level of inference. Criterion B showed higher rater agreement compared to Criterion A. Criteria A and B reflect different configurations of construct, paradigm, and level of inference. The characteristic adaptation construct and interpersonal paradigm were strongly reflected in both Criteria A and B. The psychodynamic and personological paradigms and the narrative identity construct were highly correlated, and the multivariate, empirical, and dispositional traits variables were highly correlated. Results illustrate differential conceptual emphases as well as areas of overlap with Criteria A and B. This characterization highlights that PD nosology rests on personality theory and suggests implications for integrative PD assessment.

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.

King v. Burwell: Desperately Seeking Ambiguity in Clear Statutory Text.

Does the Patient Protection and Affordable Care Act (ACA) of 2010 authorize tax credits within the thirty-six states that failed to establish health insurance exchanges? That is the question presented in Pruitt v. Burwell, Halbig v. Burwell, King v. Burwell, and Indiana v. IRS. The plaintiffs argue that the statute is clear and forecloses any possibility of tax credits in federal exchanges. The government argues that the statute plainly authorizes tax credits in federal exchanges, or is at least ambiguous on the question. Mere disagreement is not evidence of ambiguity. Reaching the truth requires wading deep into each side's arguments. Whether the relevant text is viewed in isolation or in its full statutory context, the ACA authorizes tax credits only in exchanges established by the states.

Tachydysrhythmia treatment and adverse events in patients with wolff-Parkinson-white syndrome.

BACKGROUND: Current guidelines recommend avoiding atrioventricular-nodal blocking agents (AVNB) when treating tachydysrhythmias in Wolff-Parkinson-White syndrome (WPW) patients. STUDY OBJECTIVES: We investigated medications selected and resulting outcomes for patients with tachydysrhythmias and WPW. METHODS: In this single-center retrospective cohort study, we searched a hospital-wide database for the following inclusion criteria: WPW, tachycardia, and intravenous antidysrhythmics. The composite outcome of adverse events was acceleration of tachycardia, new hypotension, new malignant dysrhythmia, and cardioversion. The difference in binomial proportions of patients meeting the composite outcome after AVNB or non-AVNB (NAVNB) treatment was calculated after dividing the groups by QRS duration. A random-effects mixed linear analysis was performed to analyze the vital sign response. RESULTS: The initial database search yielded 1158 patient visits, with 60 meeting inclusion criteria. Patients' median age was 52.5 years; 53% were male, 43% presented in wide complex tachycardia (WCT), with 75% in atrial fibrillation (AF) or flutter. AVNBs were administered in 42 (70%) patient visits. For those patients with WCT in AF, the difference in proportions of patients meeting the composite outcome after AVNBs vs. NAVNBs treatment was an increase of 3% (95% confidence interval [CI] -39%-49%), and for those with narrow complex AF it was a decrease of 13% (95% CI -37%-81%). No instances of malignant dysrhythmia occurred. Mixed linear analysis showed no statistically significant effects on heart rate, though suggested a trend toward increasing heart rate after AVNB in wide complex AF. CONCLUSION: In this sample of WPW-associated tachydysrhythmia patients, many were treated with AVNBs. The composite outcome was similarly met after use of either AVNB or NAVNB, and no malignant dysrhythmias were observed.

"Identity theft" in BRCA1/2: impact of positive genetic test results and risk-reducing interventions.

Individuals harboring breast cancer gene 1/2 (BRCA1/2) pathogenic variants are at increased lifetime risk for developing cancer. Learning one's BRCA1/2 carrier status is a watershed moment that can result in psychological distress, anxiety, and depression, as well as feelings of vulnerability and stigma. However, emotional and coping responses to learning one's BRCA1/2 carrier status and after risk-reducing interventions (i.e., preventative bilateral mastectomy) are variable, and existing literature reveals mixed and sometimes contradictory results. Drawing on the concept of narrative identity from the field of psychology, we sought to examine if "identity theft" (the sudden overtaking of one's narrative agency by an external force) may help explain the heterogeneity of emotional and coping responses following the revelation of BRCA carrier status and the subsequent medical intervention one may receive. This Perspective explores BRCA related identity theft using two case studies. Narrative analysis of qualitative interviews uncover the ways that patients experience the disintegration (theft) of their identity as well as their efforts to build and reintegrate a new BRCA carrier identity. This initial qualitative exploration provides preliminary support for the relevance of narrative identity and identity theft to hereditary cancer. We posit that applying the lens of identity theft may hold promise as a unifying concept, integrating across the variable emotional and coping responses among BRCA carriers. Employing a lens of identity theft may help inform the development of tailored narrative interventions as part of precision healthcare to support active coping and psychosocial wellbeing.

A guide for social science journal editors on easing into open science.

Journal editors have a large amount of power to advance open science in their respective fields by incentivising and mandating open policies and practices at their journals. The Data PASS Journal Editors Discussion Interface (JEDI, an online community for social science journal editors: www.dpjedi.org ) has collated several resources on embedding open science in journal editing ( www.dpjedi.org/resources ). However, it can be overwhelming as an editor new to open science practices to know where to start. For this reason, we created a guide for journal editors on how to get started with open science. The guide outlines steps that editors can take to implement open policies and practices within their journal, and goes through the what, why, how, and worries of each policy and practice. This manuscript introduces and summarizes the guide (full guide: https://doi.org/10.31219/osf.io/hstcx ).

Clients' and therapists' stories about psychotherapy.

This article provides an overview of the emerging field of research on clients' stories about their experiences in psychotherapy. The theory of narrative identity suggests that individuals construct stories about their lives in order to provide the self with a sense of purpose and unity. Psychotherapy stories serve both psychological functions. Focusing on the theme of agency as a vehicle for operationalizing purpose and coherence as a way of operationalizing unity, this article will describe the existing scholarship connecting psychotherapy stories to clients' psychological well-being. Results from cross-sectional qualitative and quantitative studies as well as longitudinal research indicate a connection between the stories clients tell about therapy and their psychological well-being, both over the course of treatment and after it is over. In addition, a preliminary analysis of therapists' stories about their clients' treatment is presented. These analyses reveal that the way therapists recount a particular client's therapy does not impact the relationships between clients' narratives and their improvement. The article concludes with a discussion of how this body of scholarship might be fruitfully applied in the realm of clinical practice.

Taxation without representation: the illegal IRS rule to expand tax credits under the PPACA.

The Patient Protection and Affordable Care Act (PPACA) provides tax credits and subsidies for the purchase of qualifying health insurance plans on state-run insurance exchanges. Contrary to expectations, many states are refusing or otherwise failing to create such exchanges. An Internal Revenue Service (IRS) rule purports to extend these tax credits and subsidies to the purchase of health insurance in federal exchanges created in states without exchanges of their own. This rule lacks statutory authority. The text, structure, and history of the Act show that tax credits and subsidies are not available in federally run exchanges. The IRS rule is contrary to congressional intent and cannot be justified on other legal grounds. Because tax credit eligibility can trigger penalties on employers and individuals, affected parties are likely to have standing to challenge the IRS rule in court.

Barriers to mental health service use among people with disabilities during the COVID-19 pandemic.

PURPOSE/OBJECTIVE: The COVID-19 pandemic has exacerbated existing health inequities for people with disabilities (PWD), including disparities in mental health needs and service use. The present study investigated prospective predisposing, enabling, and illness-related correlates of mental health service need and use among PWD during the COVID-19 pandemic. RESEARCH METHOD/DESIGN: Data were collected online at two time points: October-December 2020 and October-December 2021. U.S. adults with disabilities completed self-report measures on demographic and disability characteristics, pandemic-related stressors (e.g., worries about COVID-19), depression, anxiety, barriers to service use, and perceived mental health needs and service use. Two logistic regressions were used to examine the effect of predisposing, enabling, psychosocial barriers, and illness-related factors on perceived mental health service need and service use. RESULTS: Perceptions of mental health service needs were significantly predicted by gender (female-identified, transgender and gender diverse [TGD]), younger age, increased depressive symptoms, and presence of a prepandemic mental health condition. Among those who reported a perceived need, mental health service use was predicted by gender (female-identified and TGD), greater income, lower frequency of anticipated provider disability bias, and presence of a prepandemic mental health condition. CONCLUSIONS/IMPLICATIONS: This study provides vital descriptive data on the pattern of mental health service utilization among PWD during the COVID-19 pandemic, a uniquely disruptive, challenging time. Findings further underscore the necessity of providing disability competency training and bias reduction interventions to mental health professionals, as anticipated provider disability bias was a key factor in nonservice use of PWD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).